山西省2018—2021年慢性血栓栓塞性肺高血压的患病率及其合并症调查

Prevalence and comorbidity of chronic thromboembolic pulmonary hypertension in Shanxi province from 2018 to 2021

目的调查山西省2018—2021年慢性血栓栓塞性肺高血压(CTEPH)的患病率及其合并症情况。方法该研究为横断面调查。收集2018年1月1日至2021年12月31日山西省卫生健康统计直报系统筛选的住院病历病案首页出院诊断登记有CTEPH患者的临床资料。同时,通过山西省统计年鉴获取对应各年份山西省总人口数。以每年CTEPH患者例数为分子,以同期山西省总人口数为分母,分别计算2018、2019、2020和2021年山西省CTEPH患病率。根据国际疾病与相关健康问题统计分类第10版(ICD-10)在入选者病历显示的其他诊断中确定Charlson合并症,并计算年龄校正的Charlson合并症评分(aCCI),将合并症严重程度分为轻度(aCCI≤2分)、中度(aCCI=3~5分)、中重度(aCCI=6~8分)、重度(aCCI≥9分)。结果共查找出CTEPH患者300例,年龄(65.5±11.5)岁,2018、2019、2020、2021年分别为31、65、83及121例。2018、2019、2020和2021年山西省CTEPH的患病率分别为0.9/100万人、1.9/100万人、2.4/100万人及3.5/100万人,呈上升趋势。该研究中的CTEPH患者涉及14种Charlson合并症,其中合并慢性肺病者占比最高[198例(66.0%)],其次为周围血管疾病[126例(42.0%)]和慢性心力衰竭[121例(40.3%)],轻度、中度、中重度及重度合并症的患者分别有49例(16.3%)、169例(56.3%)、67例(22.3%)和15例(5.0%),以中度合并症者最多。结论山西省2018—2021年CTEPH患病率为(0.9~3.5)/100万人,且呈逐年上升趋势。CTEPH患者的合并症以慢性肺病为主,其次为周围血管疾病和慢性心力衰竭,以中度合并症居多。

Objective To survey the prevalence and comorbidity of patients with chronic thromboembolic pulmonary hypertension(CTEPH)in Shanxi province from 2018 to 2021.Methods The data of patients with CTEPH from 2018 to 2021 were extracted from the Health Statistics Direct Reporting System of Shanxi Provincial Health Commission;the population data of Shanxi Province was obtained from the Statistical Yearbook of Shanxi Province.The prevalence rate of CTEPH in Shanxi Province in 2018,2019,2020 and 2021 was calculated.The International Statistical Classification of Diseases and Related Health Problems 10th Revision(ICD-10)was used to identity the specific Charlson comorbidity from other diagnosis on the medical record.The severity of the comorbidity scale was classified as mild(aCCI≤2 points),moderate(aCCI=3-5 points),moderate-severe(aCCI=6-8 points),and severe(aCCI≥9 points).Result A total of 300 patients with CTEPH were identified in the whole province during the period with the mean age of(65.5±11.5)years,there were 31,65,83 and 121 cases in 2018,2019,2020 and 2021,and the corresponding prevalence rates were 0.9/106,1.9/106,2.4/106 and 3.5/106,respectively showing an increasing trend.The patients with CTEPH in this study involved 14 Charlson comorbidities,among which the chronic lung disease was in the highest proportion(198/300,66.0%),followed by peripheral vascular disease(126/300,42.0%)and chronic congestive heart failure(121/300,40.3%).There were 16.3%(49/300)of patients with mild comorbidity,56.3%(169/300)with moderate comorbidity,22.3%(67/300)with moderate-severity comorbidity,and 5.0%(15/300)with severity comorbidity.Conclusions The prevalence of CTEPH in Shanxi province from 2018 to 2021 was 0.9-3.5/106 showing an upward trend.The chronic lung disease,peripheral vascular disease and chronic congestive heart failure are the main comorbidities of patients with CTEPH,and mostly with moderate comorbidity.