Changing pattern of heart diseases in Shanghai from the 1950s to 1980s

Objective To determine the pattern of dynamic change in types of heart diseases in the past 4 decades for providing a reference to treatment and prevention of heart diseases in China. Methods All adult cardiac patients admitted to the Zhong Shan Hospital and Hua Shan Hospital from 1948 to 1989 were analyzed. The constituent ratio of different heart diseases in the 1950s, 1960s, 1970s and 1980s was compared. Results The percentage of heart diseases among medical inpatients increased in each of the recent 4 decades, from 9.89%, 15.69%, 20.90% to 23.54% respectively. The constituent ratio of different heart diseases changed, coronary heart disease constituted the highest proportion, next came rheumatic heart disease, and congenital heart disease was in third place. Congenital heart disease, myocarditis, cardiac dysrhythmia without organic heart disease, cardiomyopathy and endocarditis increased, rheumatic heart disease, pulmonary heart disease and hypertensive heart disease apparently decreased; syphilitic heart disease could rarely be encountered. Conclusion China is now facing a low overall death rate, a long life expectancy and an aging population. The incidence of heart diseases increased gradually and patterns of heart diseases kept changing. The overall trend is that heart diseases which were not related to infection are increasing while heart diseases related to bacterial infection are decreasing.

10308例心血管病住院患者病因及死因构成分析

目的：分析心血管内科住院患者的心血管疾病构成情况和死亡原因，为心血管病的临床和科研工作提供流行病学依据。方法：对2011年1月至2012年12月期间在本科室出院的患者进行回顾性调查，将患者分为44岁以下组、45-59岁组、60-75组和75岁以上4组．统计分析各组患者住院病因的构成比，死亡患者的根本病因构成比和心衰、心源性猝死在直接死因中的构成比。结果：10308例患者中男性5096例，女性5212例，年龄（65．16±14．37）岁。住院病因构成比前3位分别是冠心病4256例（41．29％）、高血压病2803例（27．19％）、心律失常1073例（10．41％）。男性与女性病因构成比前3位与总体一致。各年龄段病因构成比不同，12～44岁组前3位分别是心律失常、高血压病和病毒性心肌炎，45～49岁组和60～74岁组前3位与总体一致．75．105岁组前3位分别是冠心病、高血压病和病态窦房结综合征。患者死亡117例，死亡率1．14％，根本死因前3位分别是冠心病71例（60．68％）、高血压病17例（14．53％）、风湿性心脏病15例（12．85％）。直接死因为心衰的62例（52．99％）、心源性猝死33例（28．21％）。结论：冠心病和高血压病是导致本地区心血管病患者住院的主要原因和死亡原因，应加强防控。

冠心病合并中风证候演变规律研究

研究用聚类分析方法将冠心病合并中风分为三期6个证型,并根据证候构成比及概率转移矩阵结果总结了证候演变规律。急性期以标实(风邪、热邪)为主、本虚(脾气虚、肾阴虚)为次;恢复期以本虚标实、虚实夹杂为特征,"脾气虚+痰饮"最为突出;后遗症期以本虚(脾气虚、肾阴虚、肝血虚、肾阳虚)为主、标实(痰饮、风邪、血瘀、寒凝)为次;各阶段证候均可演变为下一阶段所有证候,体现了本病由急至缓、由重至轻的演变过程。该研究结果有助于临床医师直观地认识冠心病合并中风的本质,确定理法方药,从而提高临床辨治水平及证候的规范化水平。

冠心病(稳定性心绞痛)证候演变规律研究

采用量表学方法,设计专家问卷,分析阶段各主要证候构成比,然后采用转移概率矩阵等统计学方法和医理分析相结合,分析冠心病各阶段主要证候与病机的关系,从而确定各主要证候先后排列顺序及转化关系,由此阐明贯穿疾病全过程基本病机、证候演变规律:冠心病发病的整个过程以虚证和情志因素影响为主。