2007～2009年北京市脑血管病住院病例的流行特征及医疗现状  

Epidemiological and Medical Profile of Inpatients with Cerebrovascular Disease in Beijing(2007-2009)

作　　者：刘改芬[1] 王伊龙[1,2] 周永[1] 李子孝[1] 赵性泉[1] 王春雪[1,3] 高晓兰 郑健鹏[4] 谢学勤[4] 王拥军[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市100050 [2]首都医科大学附属北京天坛医院科研处 [3]北京市脑血管病防治指导组办公室 [4]北京市公共卫生信息中心

出　　处：《中国卒中杂志》2011年第12期938-942,共5页Chinese Journal of Stroke

基　　金：北京市科委重大项目(D101107049310005);首都医学发展科研基金资助项目(2007-1055);北京市科委科普项目(社会征集类)(Z09020600360917)

摘　　要：目的了解北京市脑血管病住院病例的流行概况和医疗现状、如年龄,性别、疾病亚型分布等,预后、疾病负担及医疗质量等情况,为制定脑血管病防治策略、评价脑血管病防治效果提供依据。方法利用2007～2009年北京市二级及以上医院住院病例监测信息系统中的脑血管病住院病例的首页及附页信息,对人口统计学信息、疾病特征、治疗情况和卫生经济学指标等进行描述性分析,并对其年度间的变化进行统计学检验。结果 2007～2009年度北京市脑血管病住院病例分别为87729、99369和109829例,平均年龄分别为(65.29±13.56)岁、(65.29±13.47)岁,(65.26±13.68)岁,3年间差异无统计学意义(P=0.13,P=0.81),但46～60年龄组住院患者的构成比呈逐年上升趋势(Z=10.11,P<0.01),男性的构成比例分别为59.6%,58.6%和58.7%;疾病亚型构成比中,脑梗死约为50.0%、短暂性脑缺血发作和相关的综合征约为20.0%、脑内出血约为8.3%、脑血管病后遗症约为3.0%、蛛网膜下腔出血约为1.6%。2007～2009年度脑血管病的住院病死率分别为3.6%、3.2%和2.8%,呈逐年下降趋势(Z=11.10,P<0.01)。脑血管病平均住院日(中位数)为15～16d。人均总费用(中位数)由2007年的8848元上升到2009年的9824元。结论北京市脑血管病住院病例数量巨大,疾病负担沉重。其疾病亚型构成与发达国家相似,但发病年龄较早,平均住院日较长。住院病死率呈逐年下降趋势。本研究结果为制定北京市脑血管病防治策略、评价脑血管病防治效果提供了基础信息。Objective To understand the epidemiological and medical risk profile of inpatients with cerebrovascular disease in Beijing, e.g., distribution of age, gender, stroke subtype, and prognosis, disease burden and medical quality, and provide evidence for make strategy for cerebrovascular disease prevention and treatment, and to evaluate the effectiveness of its prevention and treatment. Methods The data was obtained from ＂The Database of Inpatient Record from Level 2 and 3 hospitals＂ administered by Beijing Public Health information Center. Data of cerebrovascular disease in 2007-2009 were analyzed on demographic, disease characteristics, prognosis and health economic indicators through description analysis. Furthermore, the trend on changes over years was statistically tested. Results In the year of 2007, 2008 and 2009, there were 87 729, 99 369 and 109 829 inpatients diagnosed as cerebrovascular disease, respectively. The average age was （65.29±13.56）, （65.29±13.47） and （65.26±13.68）years old for 2007, 2008 and 2009 with no significant difference （F=0.13,P=-0.81）. However, the proportion of patients aged from 45 to 60 showed significantly increased（Z=10. 11, P〈0.01）.There were 59.58%, 58.6% and 58.7% of male in 2007, 2008 and 2009, respectively. As for the proportion of stroke subtype, the top five were ischemic stroke（50.0%）, transient ischemic attack（20.0%）, intracerebral haemorrhage（8.3%）, sequelae of cerebrovascular disease（3.0%） and subarachnoid haemorrhage（l.6%） in order. The in hospital case-fatality was 3.6%, 3.2% and 2.8% in 2007, 2008 and 2009 respectively, with a significant decreasing trend（Z=ll.10, P〈0.05）. The median of length of hospital stay was 15-16 days, and the median of total medical cost per-person ranged from ￥8848 in 2007 to 9824 in 2009. Conclusion There is huge number of inpatient with cerebrovascular disease in Beijing, which leads to very heavy disease burden. Compared to developed countries, the proportion of stroke subtype is sim

关 键 词：脑血管意外 流行病学研究 费用 医疗 

分 类 号：R743[医药卫生—神经病学与精神病学]