我国2001-2017年AMI患者住院病死率的系统评价

Systematic Review on Hospital Mortality of Acute Myocardial Infarction Patients from 2001 to 2017 in China

目的:系统评述2001-2017年我国急性心肌梗死患者住院病死率情况。方法:通过检索万方数据库、中国知网、维普数据库和Pub Med数据库,按照纳入、排除标准筛选,对最终入选的32篇纳入1 000例及以上受试者的文章进行系统综述。应用Meta-Analyst软件计算总体住院病死率及95%可信区间,并绘制森林图,分析性别、年龄、时间、地区等分布情况。结果:基于对现有文献报道的数据结果合并得出我国成年人急性心肌梗死患者住院粗病死率为8.5%,男性和女性粗病死率分别为8.0%和12.1%。按年龄分布,大于80岁人群病死率达到30%,与60~79岁人群13.1%比较,20~39岁及40~59岁人群病死率均为4.3%。按地区分布,西南地区病死率(19.1%)和西北地区病死率(15.3%)明显高于其他地区(华北8.8%、东北7.0%、华东7.7%、中南6.8%、华南9.6%)。按时间分布,2006-2011年粗病死率(10.3%)明显高于2000-2005年(7.8%)和2012-2017年(6.8%)。结论:我国急性心肌梗死患者住院病死率依然较高,急性心肌梗死防治策略值得进一步研究,并且需要制定急性病流行病学调查的方法指南。

Objective： To systematically review the hospital mortality rate of patients with acute myocardial infarction（ AMI） in China from 2001 to 2017. Methods： By searching Wanfang database,CNKI,VIP database and Pub Med,and screening according to inclusion and exclusion criteria,a systematic review was conducted on the 32 articles that were finally included with 1 000 subjects or more. The Meta-Analyst software was applied to calculate the overall hospital mortality rate and 95% confidence interval,and the forest map was drawn to analyze the distribution of gender,age,time and region. Results： Based on the data reported in the literature,the crude fatality rate of hospitalized patients with AMI was 8. 5%,and that of male and female patients was 8. 0% and12. 1%,respectively. According to the age distribution,the case fatality rate of people over 80 years old reached 30%. Compared with 13. 1% of people aged 60-79 years old,the case fatality rate of people aged 20 ~ 39 years old and 40 ~ 59 years old was4. 3%. According to the regional distribution,the case fatality rate（ 19. 1%） in southwest China and 15. 3% in northwest China was significantly higher than that in other regions（ 8. 8% in north China,7. 0% in northeast China,7. 7% in eastern China,6. 8%in central south and 9. 6% in south China）. According to the time distribution,the crude case fatality rate（ 10. 3%） in 2006-2011 was significantly higher than that in 2000-2005（ 7. 8%） and 2012-2017（ 6. 8%）. Conclusion： The mortality rate of hospitalized patients with AMI is still high in China,and the strategy of prevention and treatment of acute myocardial infarction is worthy of further study.