我国慢性病与疾病负担的国际比较

Mortality and burden of non-communicable diseases in China

目的 研究我国慢性非传染性疾病（NCD）导致的主要死亡原因和健康寿命损失年,与相关国家比较发现我国主要慢性病的危害程度与疾病负担特点.方法 根据世界卫生组织发布的各国因病（伤害）的死亡人数、死亡率、标准化死亡率、健康寿命损失年、每10万人健康寿命损失年、每10万人年龄标准化健康寿命损失年,按传染性疾病、慢性非传染性疾病、伤害进行大类分类,按疾病（伤害）类别进行中级分类,按病种进行小类分类后按照类别,选用R2.15分析软件绘图比较.结果 我国慢性病疾病死亡的绝对数每年约737.6万人,健康寿命损失1.41亿年,年龄标化死亡率627人/10万人,年龄标准化健康寿命损失10 829年/10万人.因慢性病导致的死亡占全死因死亡数的79.4％,健康寿命损失年占全死因健康寿命损失年的70.3％.结论 我国慢性病死亡率与健康寿命损失前三位分别为心血管疾病、恶性肿瘤、呼吸系统疾病与神经精神疾病、心血管疾病、感官疾病.在中国、英国、美国、加拿大、日本、韩国、印度7个国家中,我国疾病负担仅次于印度,其中食管癌、慢性阻塞性肺疾病的健康寿命损失为世界平均水平的6倍、2倍,糖尿病患病人数增长速度居世界前列.

Objective To assess the leading causes of death and disability adjusted life year （DALY） due to non-communicable disease （NCD） in China. Methods World Health Report 2004 published by the World Health Organization （WHO） was reviewed, including total deaths, deaths per 100 000, age- standardized death rate per 100 000, total DALYs, DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state. Diseases or injuries were assigned to three levels： communicable diseases, NCD and injuries （the first level）; categories of disease or injure （the second level）; specific diseases （the third level）. R2.15 was used for data analysis. Results NCD causes 737.6 million deaths, 141million total DALY years, 627 age standardized mortality per 100 000, and 10 829 age-standardized DALYs per 100 000. NCD account for 79.4% and 70.3% total death or all-cause DALYs. Conclusions Cardiovascular disease, malignant neoplasm and respiratory disease were the leading causes of death, while neuropsychiatric disorder, cardiovascular disease and sense organ disease were the most important causes of DALYs. Among China, the United Kingdom, the United States, Canada, Japan, Korea and India, China ranked second in age-standardized mortality rate of chronic disease. DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level. Besides, the increasing trend in the prevalence of diabetes mellitus remains impressive.