中國9省市綜合性醫院缺血性中風住院患者臨床特征分析

楊薇　謝雁鳴　趙維　莊嚴　張罡　黎明全

摘要 目的：借助醫療大數據分析缺血性中風住院患者人口學分布、住院特點和合并疾病特征以及用藥規律。方法：采集全國9省市三級甲等綜合醫院信息系統（HIS）中缺血性中風住院患者信息，采用頻數統計及關聯規則方法，分析患者人口學信息、出入院情況、合并疾病及用藥信息。結果：39 777例缺血性中風患者，年齡中位數為68歲，主要集中于60～74歲年齡段，共12 420例（31.22%），男女比為1.78∶1;入院病情急危者6 940例（18.58%），住院天數15～28 d的共14 477例（36.40%），患者主要在夏至及寒露2個節氣入院;主要因急性腦梗死住院的共31 176例（78.38%），入院診斷中風痰阻絡證701例（74.97%），氣虛血瘀證101例（11.76%）;合并疾病前3位分別為高血壓21 938例（55.15%），糖尿病8 287例（20.83%），冠心病7 921例（19.91%）;西藥使用排首位的為阿司匹林，共20 924例（52.60%），中成藥使用排首位的為疏血通注射液，共9 015例（22.66%），54.63%的患者住院期間同時使用了活血化瘀類藥物及抗血小板藥物。結論：缺血性中風住院患者年齡主要為60～89歲，男性多于女性，發病入院與節氣可能相關，合并疾病主要為高血壓、糖尿病和冠心病，中西藥物使用排首位的分別為阿司匹林和疏血通注射液，且活血化瘀類中成藥與抗血小板藥物常聯合使用。

關鍵詞 缺血性中風;住院患者特征;合并疾病;用藥規律;醫療大數據;真實世界;醫院信息系統;關聯規則

Clinical Characteristics of Inpatients with Ischemic Stroke in General Hospitals of Nine Provinces and Cities in China

YANG Wei，XIE Yanming，ZHAO Wei，ZHUANG Yan，ZHANG Gang，LI Mingquan

（1 Affiliated Hospital of Changchun University of Chinese Medicine，Changchun 130021，China; 2 Institute of Basic Research in

Clinical Medicine，China Academy of Chinese Medical Sciences，Beijing 100700，China; 3 Renmin University of China，Beijing

100872，China; 4 PLA Navy General Hospital，Beijing，100048，China; 5 Beijing FlashEx Technology Co.，Ltd.，Beijing

100080，China;6 The Third Affiliated Hospital of Changchun University of Chinese Medicine，Changchun 130021，China）

Abstract Objective：To analyze the demographic distribution，hospitalization characteristics，combined diseases，and medication regularity of inpatients with ischemic stroke with medical big data.Methods：The information of inpatients with ischemic stroke in the Hospital Information System（HIS） of tertiary grade A general hospitals in nine provinces and cities of China was collected.The demographic information，admissions and discharges，combined diseases，and medication information of patients were analyzed by frequency statistics and association rule.Results：Among the 39 777 patients with ischemic stroke，the median age was 68 years，and 12 420 cases（40.31%） were aged 60-74 years.The male/female ratio was 1.78∶1.A total of 6 940 cases（18.58%） were in critical conditions at admission.There were 14 477 cases（36.40%） hospitalized for 15-28 days，and the patients were admitted mainly in Summer Solstice and Cold Dew.A total of 31 176 cases（78.38%） were hospitalized mainly due to acute cerebral infarction，and 701 cases（74.97%） were diagnosed with stroke due to phlegm blocking collaterals，and 101 cases（11.76%） with stroke due to qi deficiency and blood stasis.The top 3 combined diseases were hypertension（n=21 938，55.15%），diabetes（n=8 287，20.83%），and coronary heart disease（n=7 921，19.91%）.Aspirin ranked first in the use of western medicine，with 20 924 cases involved（52.60%），and Shuxuetong Injection ranked first in the use of Chinese patent medicine，with 9 015 cases involved（22.66%）.The blood-activating and stasis-resolving drugs and antiplatelet drugs were used in combination by 54.63% of patients.Conclusion：The inpatients with ischemic stroke were mainly aged 60-89 years and dominated by males.The onset of the disease may be related to solar terms.The main combined diseases were hypertension，diabetes，and coronary heart disease.Aspirin and Shuxuetong Injection were the most commonly used Chinese and western medicines，and Chinese patent medicines for promoting blood circulation and removing blood stasis were often used in combination with antiplatelet drugs.

Keywords Ischemic stroke; Characteristics of inpatients; Combined diseases; Medication regularity; Medical big data; Real world; Hospital Information System; Association rule

中圖分類號：R743.3文獻標識碼：Adoi：10.3969/j.issn.1673-7202.2022.06.019

缺血性中風指因腦部血液循環障礙，缺血、缺氧所致的局限性腦組織的缺血性壞死或軟化，出現相應的神經系統功能缺損，具有高發病率、高致殘率及高致死率的特點，是目前中國人的主要致死原因[1-2]。……