上海综合性医院住院心脏病病种变化趋势

The Trend of Changes in Heart Disease Composition among Inpatients in a General Hospital of Shanghai

目的 :分析上海地区住院心脏病病种变化趋势。方法 :对 1990～ 1999年上海的综合性医院中山医院内科住院心脏病患者病种构成和流行病学特征进行描述性分析 ,共 110 0 4例 ,并与 1948～ 1989年 4个年代的研究结果比较。结果 :(1) 2 0世纪5 0～ 90年代心脏病病例数呈明显上升趋势 ,其在内科住院病例中所占的比例 80年代最高 ,90年代较 80年代轻微下降。 5个年代依次为 9.89% ,15 .6 9% ,2 0 .91% ,2 9.40 %和 2 7.6 6 %。 (2 )各种心脏病病种构成呈持续渐进变化 ,90年代各种心脏病病种构成比与过去 4个年代相比最显著的特点是冠心病继续增加 ,成为住院心脏病中的首位病因 ,占住院心脏病总数的 33 .5 7% ;其次是不明原因的心律失常 ,占 19.95 % ;风湿性心脏病构成比顺位继续下降 ,列第三位 ,占 11.76 %。 (3)其它特点 :高血压性心脏病、心肌炎、原发性心肌病、二尖瓣脱垂综合征、老年性退行性心瓣膜病变和原发性肺动脉高压呈上升趋势 ;先天性心脏病明显下降。 (4)住院心脏病病死率呈明显下降趋势 ,5个年代依次为 17.91% ,11.5 1% ,14.0 7% ,6 .14%和 2 .5 %。结论 :上世纪后 5 0年 ,上海地区住院心脏病病种的构成显著改变 ,冠心病等与人口老龄化有关的心脏病增多 。

Objective: To estimate the trend of changes in etiologic types of heart disease in Shanghai area from 1948 to 1999. Methods: Analysis of the data of heart disease composition in 1990s in Zhongshan Hospital, a general hospital of Shanghai, and comparison with the results from 1948 to 1989, total 11004 subjects were surveyed. Results: (1) The total number of heart disease cases increased steadily from 1950s to 1990s, the percentage of heart diseases among the inpatients in medical wards peaked in the 1980s and has mildly declined in 1990s, for each decades from 9.89%,15.69%,20.91%,29.40% to 27.66%, respectively. (2) The constituent ratios of different etiologic type of heart disease was changed, coronary heart disease became the largest proportion of heart disease, accounted for 33.57%, next in number cames cardiac dysrhythmias which made up 19.95%, and rheumatic heart disease was in the third place, accounted to 11.76%. (3) The incidence of hypertensive heart disease, myocarditis, cardiomyopathy, mitral valve prolapse syndrome, degenerate valvular heart disease and pulmonary hypertension increased, congenital heart disease decreased. (4) During 1948～1999 decreasing trend were observed in heart disease morbidity, from 17.91%,11.51%,14.07%,6.14% to 2.5%,respectively. Conclusion: The heart disease composition of the Shanghai population has changed dramatically in the second half of last century, more attention should be paid on achieving long-term prevent and treatment of age-related heart disease such as coronary heart disease in Shanghai in the this century.