上海市杨浦区慢性阻塞性肺疾病的共患病分析

Analysis of co-morbidities of chronic obstructive pulmonary disease for patients in Yangpu District of Shanghai

目的分析上海市杨浦区居民慢性阻塞性肺疾病(COPD)共患病的特点。方法根据上海市杨浦区疾病预防与控制中心提供的数据,选择2003—2011年居民死亡医学证明书中死亡年龄≥40岁的患者作为研究对象,筛选COPD死亡病例。将直接死亡原因(医学证明书死亡原因的第一部分)和促进死亡原因(医学证明书死亡原因的第二部分)共同定为非根本死亡原因。结果 2003—2011年,上海市杨浦区年龄≥40岁居民死亡总人数为63 161。COPD全因死亡人数为8 838(根本死亡原因5 678人),平均年龄为(81.3±7.6)岁,其中男性5 555人,女性2 783人。当COPD作为非根本死亡原因时,常见根本死亡原因为缺血性心脏病(33.4%)、脑血管疾病(14.8%)、肺癌(14.4%)和糖尿病(3.6%);随年龄增长,癌症死亡原因所占比例逐渐降低而心血管疾病逐渐上升(P<0.05),脑血管疾病则无明显变化(P>0.05)。当COPD作为根本死亡原因时,常见非根本死亡原因为肺源性心脏病(25.3%)、缺血性心脏病(23.2%)、脑血管疾病(13.9%)、糖尿病(8.8%)和癌症(4.5%)。结论心血管疾病、癌症、脑血管疾病和糖尿病为上海市杨浦区COPD患者的常见伴随疾病。

Objective To analyze the features of co-morbidities of chronic obstructive pulmonary disease （COPD） for residents in the Yangpu District of Shanghai. Methods According to the data provided by the Center for Disease Control and Prevention of the Yangpu District of Shanghai, patients whose death ages in medical certificates of death from 2003 to 2011 were ≥40 years and one of death causes was COPD were selected. The immediate cause of death （Part Ⅰ of death causes of the medical certificate） and contributing cause （ Part Ⅱ of death causes of the medical certificate） were coUectively designated as non-underlying causes of death. Results From 2003 to 2011, 63 161 patients whose ages were ≥ 40 years were died in the Yangpu District of Shanghai. A total of 8 838 patients died of GOPD （underlying cause for 5 678 patients） and the average age was （81.3 ±7.6） years. Among them, there were 5 555 male patients and 2 783 female patients. When COPD was considered as the non-underlying causes of death, the common underlying causes of death were ischemic heart diseases （33.4%）, cerebrovascular diseases （14. 8% ）, lung cancer （14.4%）, and diabetes （3.6%）. With the increase of age, the proportion of cancer gradually decreased and the proportion of cardiovascular diseases gradually increased （P〈0.05）, while the proportion of cerebrovascular diseases did not change significandy （P〉0.05）. When COPD was considered as the underlying cause, the common non-underlying causes of death were pulmonary heart diseases （25.3%）, ischemic heart diseases （23.2%）, cerebrovascular diseases （13.9%）,diabetes （ 8.8% ）, and cancer （ 5.5% ）. Conclusion Cardiovascular diseases, cancer, cerebrovascular diseases, and diabetes were common co-morbidities of COPD patients in Yangpu District of Shanghai.