北京市中关村地区心脑血管病病死率及防治策略的流行病学研究

The epidemiologic study of case fatality rate and preventive and therapeutic measure of acute coronary and cerebral apoplexy event from 1984 to 2000 in Zhongguancun area of Beijing

目的:对中关村地区1984至2000年急性冠心病、脑卒中事件病死率进行流行病学分析,为制定有效的降低病死率的防制措施提供依据。方法:以北京地区人群心血管病动态监测方案中,中关村地区近4万监测人群中1984年至2000年发生的急性冠心病、脑卒中事件为研究样本,分析病死率的变化趋势及在不同特征人群中的分布情况。结果:该地区急性冠心病事件年平均病死率为53.6%,医院内病死率为35.6%。有冠心病史人群病死率为65.0%,无此病史人群病死率为43.6%,差异有统计学意义(P<0.05);脑卒中年平均病死率为12.5%,女性脑卒中病死率呈下降趋势(P<0.05)。结论:健全以社区为单位的急救系统,提高社区居民使用急救系统的认识和能力,是争取并缩短院前救治时间,降低病死率的重要措施。

Objective：Study the case fatality rate of acute coronary and cerebral apoplexy event from 1984 to 2000 in Zhongguancun area of Beijing and provide the evidence in order to make effective preventive and therapeutic measure through which decrease the case fatality rate in this area. Methods：To analyze case fatality rate and its disposition in different people of acute coronary and cerebral apoplexy event in about 40 thousand people in MONICA project from 1984 to 2000 in Zhongguancun area. Results：The annual mean case fatality rate of acute coronary events is 53. 6% ,35. 6% in the hospital. The case fatality rate of the people who have had acute coronary is 65. 0% ,which is higher than the case fatality rate of the people who have not had acute coronary 43. 6% （P 0. 05）; the annual mean case fatality rate of cerebral apoplexy is 12. 58% ,the case fatality rate of cerebral apoplexy is descent in female（P 0. 05）. Conclusion：The important measure to short the diagnosis time and reduce the case fatality rate of acute coronary and cerebral apoplexy event should including improving community based emergency service and raising awareness and capabilities of community residents using the emergency service.