1990-2010年我国城乡成年人群脑血管疾病死亡率的流行趋势

Trends in cerebrovascular disease mortality in China between 1990-2010

目的探讨近20年我国城乡成年人群脑血管疾病死亡率的流行趋势。方法利用《全国卫生统计年报/鉴》中城市和农村地区的分性别分年龄的汇总数据,采用标化死亡率进行不同时点和不同人群脑血管病死亡率的比较,Poisson回归模型进行死亡率的趋势分析,年龄-时期-队列模型法探讨脑血管病的时期、队列和年龄效应。结果 (1)近20年城市人群脑血管病死亡率呈现明显下降趋势,年平均下降率男性约为3.11%,女性约为3.30%,而农村人群则无明显升高或下降趋势;(2)控制了时期和出生队列因素的影响,脑血管疾病的死亡风险随着年龄的增加而增加;(3)控制了时期和年龄因素的影响,出生年代越近,人群脑血管疾病的死亡风险越高。结论城乡成年人群中脑血管疾病所致的疾病负担日益增加;针对病因的初始预防和一级预防应该脑血管疾病人群防治的重点,中年人群可能是防治的重点人群;二级和三级预防中,农村人群不应被忽视。

Objective To examine the trends in cerebrovascular disease mortality in China by age, time period and birth cohort from 1990 to 2010. Methods The mortality data were collected from the vital registration system of the Ministry of Health. Age standardized mortality rate was calculated in order to compare mortality rates. Secular trends in the mortality of cerebrovascular disease were evaluated through Poisson regression models. Age-period-cohort model was used to estimate effects underlying the observed trends. Results The mortality rates of cerebrovascular disease remained decline a- mong the urban residents and the average annual per cent change was 3. 11% in male and 3.30% in female during 1990 - 2010. While mortality rates were fluctuated at 255/100 000 in male and 170/100 000 in female among the rural residents during the study period. Age-period-cohort model indicated the mortality risk increased with age, and the mortality develop- ment was predominantly a cohort effect, where the rise in relative risk was in successive birth cohorts. Conclusions Our results suggest that the diseases burden of cerebrovascular disease were increasing, and middle aged and rural residents should be paid more attention in the population prevention of cardiovascular disease.