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摘要:
目的 了解安徽省居民心血管病(cardiacvascular diseases, CVDs)死亡变化特征和寿命损失情况。 方法 收集全国“人口死亡信息登记管理系统”中2013-2018年安徽省24个疾病监测点数据，分析CVDs死亡率并采用年度变化百分比(annual percent change, APC)检验其变化趋势，采用潜在减寿年数(potential years of life lost, PYLL)、减寿率(potential years of life lost rate, PYLLR)、平均减寿年数(average years of life lost, AYLL)评价其疾病负担。 结果 2013-2018年安徽省CVDs标化死亡率260.36/10万，呈逐年下降趋势(APC%=-2.53%)。CVDs死亡率男性＞女性、农村＞城市、皖北＞皖中＞皖南，CVDs是全人群首位死因，占48.58%，其PYLLR为12.86‰，AYLL为11.13年。其中脑出血和缺血性心脏病的PYLLR最高，分别为4.69‰和4.28‰。AYLL居前3位的分别为慢性风湿性心脏病、脑出血和缺血性心脏病。 结论 安徽省CVDs防控取得一定效果，但疾病负担仍较重，应加强对高危人群的防控。 Abstract:Objective To understand the characteristics and life loss of cardiovascular diseases (CVDs) death among residents in Anhui Province. Methods The data of 24 death surveillance points in Anhui Province from 2013 to 2018 in the national "death information registration management system" was collected. The mortality of CVDs was analyzed, and the change trend of CVDs mortality was tested by annual percent change (APC). Potential years of life lost (PYLL), potential years of life lost rate (PYLLR) and average years of life lost (AYLL) were used for disease burden assessment. Results From 2013 to 2018, the standardized mortality rate of CVDs in Anhui Province was 260.36/100 000, showing a decreasing trend year by year (APC%=-2.53%). The CVDs mortality rate was higher in men than in women, and higher in rural areas than in urban. And it is the highest in Northern Anhui, followed by central Anhui, and the lowest in southern Anhui. CVDs were the first cause of death in the whole population (48.58%), with PYLLR of 12.86‰ and AYLL of 11.13 years. PYLLR was the highest in cerebral hemorrhage (4.69 ‰) and ischemic heart disease (4.28 ‰). AYLL ranked the top three in chronic rheumatic heart disease, cerebral hemorrhage and ischemic heart disease. Conclusion The prevention and control of CVDs in Anhui Province has received some achievement, but the burden of disease is still heavy, the prevention and control of high-risk groups should be strengthened. -
Key words:
- Cardiovascular disease /
- Mortality /
- Trend analysis /
- Disease burden
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表 1 2013-2018年安徽省CVDs死亡率及标化死亡率(1/10万)
Table 1. Mortality and standardized mortality of CVDs in Anhui Province from 2013 to 2018 (1/100 000)
年份 合计 性别 城乡 地区 男 女 城市 农村 皖南 皖中 皖北 年粗率 2013 319.24 335.73 302.47 280.47 347.17 242.73 305.12 360.89 2014 322.14 337.22 306.65 290.84 344.92 255.75 321.04 349.26 2015 329.03 346.32 311.93 307.52 344.90 259.74 321.80 363.02 2016 339.53 351.99 326.92 318.78 355.04 286.49 339.51 361.54 2017 336.69 346.13 326.89 316.05 352.01 283.48 336.97 358.54 2018 352.77 364.29 340.83 334.05 366.54 303.51 352.69 372.86 合计 333.50 347.14 319.49 308.40 351.87 272.58 329.74 361.10 APC(%) 1.91 1.45 2.42 3.37 3.37 4.45 2.67 0.68 t值 6.68 4.06 8.97 7.77 7.77 8.04 7.03 1.51 P值 0.003 0.015 0.001 0.001 0.001 0.001 0.002 0.205 年标化率 2013 273.95 319.32 a 231.70 244.06 295.20 b 205.83 247.65 c 330.56 2014 277.22 322.73 a 234.74 253.52 294.31 b 218.19 261.31 c 320.93 2015 267.57 312.83 a 226.38 263.98 270.26 b 211.48 240.61 c 322.30 2016 251.58 292.30 a 213.31 250.60 252.65 b 214.11 229.88 c 293.58 2017 257.27 294.80 a 220.33 251.78 261.27 b 207.76 238.69 c 301.14 2018 242.38 284.41 a 202.76 234.62 247.92 b 214.40 233.09 c 266.21 合计 260.36 302.78 a 220.47 249.22 268.21 b 212.13 240.98 c 302.78 APC(%) -2.53 -2.59 -2.59 -0.77 -3.64 0.20 -1.76 -3.83 t值 -4.68 -5.34 -3.92 -0.78 -4.84 0.35 -2.06 -4.39 P值 0.009 0.006 0.017 0.477 0.008 0.745 0.109 0.012 注：a与同年女性比较，P＜0.05；b与同年城市比较，P＜0.05；c与同年皖北和皖南比较，P＜0.05。 
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表 2 2013-2018年安徽省CVDs死亡率(1/10万)在各年龄组间的变化趋势
Table 2. Change trend of CVDs mortality (1/100 000) among age groups in Anhui Province from 2013 to 2018
年份 年龄(岁) 0~＜15 15~＜45 45~＜65 ≥65 2013 1.07 14.62 144.80 2 608.77 2014 1.05 14.13 144.96 2 641.38 2015 0.77 14.04 141.73 2 603.99 2016 1.01 12.77 142.65 2 417.24 2017 0.41 11.62 140.79 2 534.85 2018 0.65 11.32 154.55 2 428.70 合计 0.82 13.08 144.80 2 531.24 APC(%) -13.48 -5.45 0.70 -1.57 t值 -2.06 -7.60 0.84 -2.46 P值 0.109 0.002 0.449 0.070
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表 3 2013-2018年安徽省不同类型CVDs死因构成(%)及标化死亡率(1/10万)变化趋势
Table 3. Trend of composition of death cause (%) and standardized mortality (1/100 000) of different types of CVDs in Anhui Province from 2013 to 2018
变量 2013年 2014年 2015年 2016年 2017年 2018年 APC(%) t值 P值 构成比 心脏病 46.55 46.58 46.11 45.47 46.52 47.51 0.24 0.66 0.545 慢性风湿性心脏病 0.75 0.74 0.69 0.74 0.58 0.49 -7.66 -3.30 0.030 高血压性心脏病 5.76 7.46 8.02 7.72 7.45 7.83 4.36 1.74 0.157 缺血性心脏病 31.85 33.69 35.02 35.54 36.63 37.69 3.22 10.65 0.000 肺源性心脏病 5.04 2.49 0.74 0.28 0.24 0.23 -48.77 -5.96 0.004 脑血管病 51.98 52.20 52.96 53.69 52.67 51.70 0.04 0.10 0.926 脑出血 26.24 24.82 24.35 23.48 21.59 20.75 -4.54 -11.33 0.000 脑梗死 13.71 15.46 16.01 16.78 17.75 17.63 5.04 5.99 0.004 中风未特指 1.87 1.66 1.58 1.40 1.00 1.10 -11.55 -5.34 0.006 标化死亡率 心脏病 126.48 128.23 121.87 113.29 118.23 113.49 -2.42 -3.46 0.026 慢性风湿性心脏病 2.09 2.09 1.91 1.99 1.62 1.36 -7.94 -4.02 0.016 高血压性心脏病 15.54 20.31 20.77 18.70 18.42 17.89 0.88 0.32 0.766 缺血性心脏病 86.66 92.67 92.68 88.57 93.07 90.16 0.47 0.64 0.559 肺源性心脏病 13.42 6.83 1.97 0.74 0.62 0.56 -49.67 -6.30 0.003 脑血管病 143.39 145.55 143.11 136.08 136.86 126.90 -2.39 -3.95 0.017 脑出血 73.64 70.63 67.93 62.19 59.10 54.33 -5.94 -14.78 0.000 脑梗死 36.93 42.19 42.00 40.92 44.40 41.33 1.99 1.52 0.203 中风未特指 5.07 4.51 4.16 3.42 2.52 2.54 -14.31 -8.36 0.001
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表 4 2013-2018年安徽省CVDs所致潜在减寿情况
Table 4. Potential life loss caused by CVDs in Anhui Province from 2013 to 2018
变量 PYLL(人年) PYLLR(‰) AYLL(年) CVDs分类 心脏病 485 746 5.67 11.73 慢性风湿性心脏病 14 202 0.17 14.35 高血压性心脏病 47 247 0.55 8.98 缺血性心脏病 366 035 4.28 11.58 肺源性心脏病 10 327 0.12 9.18 脑血管病 598 720 6.99 10.65 脑出血 401 200 4.69 12.33 脑梗死 103 349 1.21 8.00 中风未特指 9 803 0.11 8.88 性别 男 734 637 16.95 11.72 女 366 364 8.67 10.13 城乡 城市 452 244 12.42 11.66 农村 648 757 13.18 10.80 地区 皖南 145 317 9.05 10.84 皖中 370 378 12.17 10.73 皖北 585 305 14.96 11.49 CVDs合计 1 101 001 12.86 11.13 全死因 3 722 025 43.47 14.86
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