中国9省市综合性医院缺血性中风住院患者临床特征分析

目的：借助医疗大数据分析缺血性中风住院患者人口学分布、住院特点和合并疾病特征以及用药规律。方法：采集全国9省市三级甲等综合医院信息系统（HIS）中缺血性中风住院患者信息，采用频数统计及关联规则方法，分析患者人口学信息、出入院情况、合并疾病及用药信息。结果：39 777例缺血性中风患者，年龄中位数为68岁，主要集中于60～74岁年龄段，共12 420例（31.22%），男女比为1.78:1；入院病情急危者6 940例（18.58%），住院天数15～28 d的共14 477例（36.40%），患者主要在夏至及寒露2个节气入院；主要因急性脑梗死住院的共31 176例（78.38%），入院诊断中风痰阻络证701例（74.97%），气虚血瘀证101例（11.76%）；合并疾病前3位分别为高血压21 938例（55.15%），糖尿病8 287例（20.83%），冠心病7 921例（19.91%）；西药使用排首位的为阿司匹林，共20 924例（52.60%），中成药使用排首位的为疏血通注射液，共9 015例（22.66%），54.63%的患者住院期间同时使用了活血化瘀类药物及抗血小板药物。结论：缺血性中风住院患者年龄主要为60～89岁，男性多于女性，发病入院与节气可能相关，合并疾病主要为高血压、糖尿病和冠心病，中西药物使用排首位的分别为阿司匹林和疏血通注射液，且活血化瘀类中成药与抗血小板药物常联合使用。

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

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.