北京地区4960例慢性阻塞性肺疾病住院患者合并卒中情况的多中心临床调查

Chronic obstructive pulmonary disease accom panying stroke:Amulticenter investigation of 4960 patients in Beijing

目的研究10年间住院慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者脑卒中患病比例、人群分布、年龄和性别的相关性。方法对2000年1月一2010年3月间解放军总医院、北京协和医院及北京医院的住院病案数据库进行现况调查分析。结果入选住院患者共46701例，其中COPD4960例，占10．62％；COPD合并脑卒中808例，占16．29％，男性592例，女性216例，平均年龄（70．2±11．1）岁。各年龄段COPD男性患者患病比例均高于女性，并随年龄增长而升高；不同年龄（〈50岁、50～59岁、60～69岁、70—79岁及≥80岁）COPD的患病比例分别为1．81％、4．25％、7．97％、22．49％和41％。COPD患者发生脑卒中的风险明显高于非COPD患者（HR2．97，95％CI2．59％-3．40％），男女COPD患者在脑卒中风险方面差异无统计学意义（P=0．372）。各年龄段COPD与非COPD患者脑卒中患病比例均有统计学差异俨均〈0．01）。结论COPD是导致脑卒中发生和发展的重要危险因素之一。

Objective To study the correlation of prevalence and distribution in patients with stroke due to chronic obstructive pulmonary disease （COPD） over the past 10 years with their age and gender. Methods Patients with stroke due to COPD admitted to Chinese PLA General Hospital, PUMC Hospital and Beijing Hospital from January 2000 to March 2010 were investigated according to the medical records databases. Results Of the 46 701 patients included in this study, 4 960 （10.62%） suffered from COPD. Of these 4 960 COPD patients （592 males and 216 females with an average age of 70.2±11.1 years, 808 （16.29%） were complicated with stroke. The prevalence of COPD was higher in male patients than in female patients and increased with their age. The prevalence of COPD was 1.81%, 4.25%, 7.97%, 22.49% and 41% respectively in the patients with their age 〈 50, 50-59, 60- 69, 70-79 and≥ 80 years. The risk of stroke was significantly higher in COPD patients than in non-COPD patients （HR=2.97, 95% CI：2.59%-3.40%）. No significant difference was observed in the prevalence of stroke among male and female COPD patients （P=0.372）. However, a significant difference was found in the prevalence of stroke among COPD and non-COPD patients at different ages （P 〈 0.01）. Conclusion COPD is one of the important risk factor for the occurrence and development of stroke.