山西省2018~2021年先天性心脏病相关肺动脉高压患病率及流行病学特征分析

Prevalence and epidemiological characteristics of congenital heart disease-related pulmonary arterial hypertension in Shanxi Province from 2018 to 2021

目的了解山西省先天性心脏病相关肺动脉高压(CHD-PAH)的患病率及流行病学特征,为制定CHD-PAH的防治策略提供科学依据。方法该研究为横断面回顾性研究,数据来源于2018~2021年山西省卫生健康统计直报系统住院患者病案首页信息,筛选出院诊断登记有“先天性心脏病(或先天性心脏畸形)和肺动脉高压”的患者。收集患者的年龄、性别、职业、婚姻状况等人口学资料、入院途径、入院医院等级、住院总费用等相关住院资料,分析流行病学特征。结果2018~2021年山西省病案首页出院诊断中有肺动脉高压患者65189例/人次,其中CHD-PAH 2147例/人次,CHD-PAH年均患病率为1.51/10万。CHD-PAH占肺动脉高压患者比例逐年下降。从2018~2021年总体来看,女性患病率均高于男性。0~6岁的患者历年均占比最高。不同年份患者职业分布不同,以农民及无业人员多见。患者入院途径以门诊为主,入院级别以省级医院多见。春夏季患者入院较多。患者平均住院日为9~10 d,住院总费用呈逐年增长趋势。疾病分类特征显示CHD-PAH患者中,房间隔缺损患者占比最多,其次为室间隔缺损,主动脉骑跨占比最少。结论通过详细描述山西省CHD-PAH的患病率及流行病学特征,对提高疾病认识,制定最佳预防策略、早期诊断、治疗时机和治疗选择具有重要意义。

Objective To understand the prevalence and epidemiological characteristics of congenital heart disease-related pulmonary hypertension(CHD-PAH)in Shanxi Province,and provide scientific basis for formulating CHD-PAH prevention and treatment strategies.Methods This study is a cross-sectional retrospective study,with data sourced from the first page of inpatient medical records in Shanxi Provincial Health Statistics Direct Reporting System from 2018 to 2021.The patients with“CHD(or congenital heart malformation)and PAH”were screened for discharge diagnosis and registration.The demographic data were collected including age,gender,occupation and marital status,and relevant hospitalization data such as admission routes,hospital level and total hospitalization costs from the patients.The epidemiological characteristics were analyzed.Results From 2018 to 2021,there were 65189 patients with PAH diagnosed on the first page of medical records in Shanxi Province,including 2147 cases of CHD-PAH per person.The average annual prevalence of CHD-PAH was 1.51/100000.The proportion of CHD-PAH in patients with PAH decreased year by year.Overall,from 2018 to 2021,the prevalence of CHD-PAH in women was higher than that in men.The proportion of patients aged from 0 to 6 was the highest over the years.The occupational distribution of patients varied in different years,with farmers and unemployed individuals being more common.The patient’s admission route was mainly outpatient,and hospital level was commonly provincial hospital.Patients were admitted more frequently in spring and summer.The average length of hospital stay for the patients was from 9 to 10 d,and the total cost of hospitalization increased year by year.The disease classification characteristics showed that among CHD-PAH patients,the proportion of patients with atrial septal defect is the highest,followed by ventricular septal defect,and the proportion of aortic crossing was the lowest.Conclusion A detailed description of the prevalence and epidemiological characteristics of CHD-PAH in Shanxi Province is of great significance for improving understanding of the disease,formulating the optimal preventive strategies,early diagnosis,treatment timing and treatment selection.