摘要目的 总结≥80岁高龄老年人常患疾病谱及主要死亡原因,为老年疾病流行病学及预防保健提供依据. 方法 回顾性分析1969年4月1日至2013年10月31日北京医院病理科资料库的系统病理解剖资料,纳入60～106岁老年尸体解剖病例,共922例,分为60～79岁组(456例)和≥80岁组(466例).通过与60～79岁组比较,总结≥80岁老年人常患疾病谱及主要死亡原因. 结果 ≥80岁老年患者发病前15位的病理结果为慢性肾盂肾炎62.2％(290例)、冠心病59.2％(276例)、支气管肺炎52.6％(245例)、前列腺增生58.1％(232/399)、胸腔积液47.9％(223例)、恶性肿瘤47.4％(221例)、慢性支气管炎43.1％(201例)、肺淤血或水肿42.1％(196例)、心包积液41.8％(1 95例)、陈旧心肌梗死40.1％(187例)、肺气肿36.3％(169例)、慢性膀胱炎22.7％(106例)、胆囊结石胆囊炎14.2％(66例)、急性心肌梗死13.7％(64例)、消化道出血12.4％(58例).≥80岁老年人死亡原因排第一位的是恶性肿瘤47.4％(221例),第二位感染性疾病26.6％(124例),感染性疾病中最常见为肺炎24.0％(112例),第三位为心血管疾病(心肌梗死心力衰竭)25.2％(115例). 结论 ≥80岁高龄老人易患疾病包括慢性肾盂肾炎、冠心病、支气管肺炎、恶性肿瘤,死亡原因前三位分别是恶性肿瘤、心血管疾病、肺炎.对≥80岁住院患者应加强上述疾病的筛查和管理.

abstractsObjective To summarize the prevalence of diseases and main causes of death in elderly patients aged 80 and over,and to provide epidemiological evidence for preventive care of geriatric diseases.Methods A total of 922 autopsy cases aged from 60 to 106 at our hospital from April 1,1969 to October 31,2013 were analyzed.The disease spectrum and the main causes of death in cases aged 80 and over were compared with those in cases aged from 60 to 79.Results The top fifteen pathological diagnoscs in elderly patients aged 80 and over were chronic pyelonephritis(62.2 ％,290 cases),coronary heart disease(59.2％,276 cases),bronchopneumonia(52.6％,245 cases),prostatic hyperplasia (58.1％,232/399),pleural effusion (47.9％,223 cases),malignant tumor (47.4 ％,221 cases),chronic bronchitis(43.1 ％,201 cases),pulmonary congestion or edema(42.1 ％,196 cases),pericardial effusion (41.8 ％,195 cases),old myocardial infarction (40.1 ％,187 cases),emphysema (36.3％,169 cases),chronic cystitis (22.7％,106 cases),gallstones or cholecystitis (14.2％,66 cases),acute myocardial infarction (13.7％,64 cases),and gastrointestinal bleeding (12.4 ％,58 cases).The leading causes of death were malignant tumor (47.4 ％,221 cases),infectious disease(26.6％,124 cases)with pneumonia as the most prevalent type(24.0％,112 cases),and cardiovascular disease (myocardial infraction and heart failure) (24.7％,115 cases).Conclusions The most prevalent diseases in patients aged 80 and over are chronic pyelonephritis,coronary heart disease,bronchopneumonia,and malignant tumor.The top three causes of death in the aged are malignant tumor,cardiovascular disease.and pneumonia.Enhanced screening and management of the above diseases for inpatients aged 80 and over are recommended.