以阻塞性肺疾病为根本死因患者的特征分析

Multivariate analysis on death of obstructive pulmonary disease as an underlying cause

目的分析上海市杨浦区2003-2016年以阻塞性肺疾病(OLD)为根本死亡原因患者的相关因素特征,为进一步研究和制定有针对性的防治措施提供依据。方法根据上海市杨浦区疾病预防控制中心提供的数据,选择居民死亡医学证明书死亡原因栏填写为OLD的患者为研究对象,进行OLD根本死因死亡患者的多因素分析。结果当OLD作为根本死因时,2003-2016年间杨浦区OLD死亡患者的直接死因依次为其他阻塞性肺疾病(32.6%)、慢性支气管炎(20.7%)和肺源性心脏病(17.2%)等;其主要相关死因为心血管疾病(50.0%)、脑血管疾病(9.8%)和糖尿病(6.2%)。OLD为根本死因,死亡发生在医疗场所(包括医院和急诊室)为最多,约占70.4%;比较在医院内外死亡的OLD根本死亡患者,性别、婚姻状况及受教育程度在两组之间均存在差异。OLD根本死因死亡数亦具有显著的季节差异性,其中冬季死亡人数最多。结论2003-2016年间上海市杨浦区以阻塞性肺疾病(OLD)为根本死亡原因患者的多因素死亡特征明显,可针对性采取综合预防控制措施。

Objective To analyze the characteristics among people who died with a diagnosis of obstructive lung disease(OLD)as an underlying cause in Yangpu District of Shanghai from 2003 to 2016,and to provide basis for further research and development of targeted prophylactico-therapeutic measures.Methods The death data from the Shanghai Yangpu District Center for Disease Control and Prevention for Medical Cause of Death database were analyzed,and all death certificates for individuals on which OLD were listed as the underlying cause were selected.Results When OLD was used as the underlying cause of death from 2003 to 2016,the associated causes were cardiovascular disease(50%),cerebrovascular disease(9.8%)and diabetes(6.2%).Meanwhile,the direct causes of death in OLD patients were other obstructive pulmonary diseases(32.6%),chronic bronchitis(20.7%)and pulmonary heart disease(17.2%).The most common place of death in OLD was at medical sites(including hospitals and emergency rooms),accounting for about 70.4%.There were differences in the gender,marital status and education level of the OLD patients who died in or outside the hospital between the two groups.It was able to present a seasonal variation,with peaks in winter months,of OLD identified as underlying causes of death.Conclusion Multiple-cause mortality analysis provides the characteristics of diseases which OLD are listed as the underlying cause are obvious,which can be targeted to take comprehensive prophylactico-therapeutic measures.