Chest:王辰、翟振国教授团队再发文——近10年中国VTE人群患病率上升,而病死率显著下降

2019-02-16 佚名 呼吸界

时隔一月,国际呼吸领域知名期刊Chest(影响因子IF=7.652)杂志再次正式在线发表王辰院士、翟振国教授团队关于中国人群静脉血栓栓塞症(含肺栓塞与深静脉血栓形成)近十年的流行病学大数据。

时隔一月,国际呼吸领域知名期刊Chest(影响因子IF=7.652)杂志再次正式在线发表王辰院士、翟振国教授团队关于中国人群静脉血栓栓塞症(含肺栓塞与深静脉血栓形成)近十年的流行病学大数据。

本项研究数据来自全国肺栓塞与肺血管病防治协作组与国家十三·五肺栓塞精准研究团队的研究结果,共包含了国内90家医院的研究数据,从2007年至2016年,基于住院患者资料及2010年我国人口普查数据获得的肺栓塞人群患病率从2007年的1.2/100 000上升至2016年的7.1/100 000,我国肺栓塞住院期间病死率从8.5%下降为3.9%。这样的结果与多年来国内有识之士大力推动、多学科专家紧密协作、系列指南出台、诊治规范推广及国家系列科技支撑研究课题的深入开展等关系密切。

近10年,各家医院诊治PE与DVT的病例数不断攀升,整体例数增加5倍之多。除与我国VTE诊断意识及手段提高为这一要素相关之外,医院获得性VTE事件(即住院后新发VTE)增加已成为主要因素。医院内VTE防治形势严峻。未来,我国医院内VTE防治体系建设将成为VTE领域重要工作内容之一。

主要研究方法 

该研究入组2007~2016年,我国90家医院(分布与我国大陆地区主要省市地区)根据第10次修订的国际疾病分类(ICD-10)主要诊断为肺栓塞或深静脉血栓形成的20岁以上的患者数据。收集患者基本信息、住院时间、合并疾病、出院转归等内容。同时利用入组医院所在地市级2010年人口普查数据进行统计分析。总结我国2007~2016年VTE、PE、DVT患病率、死亡率、住院时间(LOS)和合并症的趋势。

主要研究结果 

90家医院10年间,共入组主要诊断为VTE 105,723例,其中43,589例为PE患者(伴或不伴DVT)。对于VTE患者,年龄性别校正的患病率从2007年的3.2/10万人上升到2016年17.5/10万人,PE患病率从1.1/10万人增加至6.3/10万。虽然患病率大幅上升,但VTE院内死亡率从4.6%降低到2.1%,PE死亡率从8.5%降低到3.9%。VTE的平均住院日从14天下降至11天,PE由17天下降至12天。

作者深入分析了2016年的数据,结果显示,老年男性患者(对于年龄≥85岁的患者,男性vs.女性,155.3 vs 125.4/10万人,P <0.001),和中国北方患者(北方 vs 南方,18.4/10万人 vs 13.4/10万人,P <0.001)的VTE患病率较高。癌症患者和Charlson合并症指数(CCI)> 2的患者病死率较高。同样,在PE和DVT患者中也观察到类似的趋势。

随后作者将本研究数据与国际近年来类似研究进行了比较。结果提示,同一阶段,中国大陆的VTE、PE患病率远低于欧美国家及地区,但死亡率与国际相仿,平均住院日明显高于国际数据。

本研究最大的意义在于,填补了我国VTE、PE近年来流行病学空白,为我们了解疾病负担添加了充分的数据支持。

原始出处:
Zhu Zhang, Jieping Lei, Xiang Shao, et al. Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China. Chest. Feb 2019.


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    2019-08-05 仁医06
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