2007-2016年中国居民慢性非传染性疾病死亡水平与变化趋势

Mortality and trend of chronic non-communicable diseases in China from 2007 to 2016

目的分析2007-2016年中国居民慢性非传染性疾病死亡水平、死亡构成比以及变化趋势,为制定防控策略提供科学依据。方法利用中国死因监测系统收集2007-2016年居民死因监测数据,分析不同性别、城乡和地区的中国居民慢性病粗死亡率、年龄标化死亡率以及死亡构成比变化情况。采用2010年第6次人口普查的人口构成计算年龄标化死亡率,采用Excel 2016软件进行数据整理,采用Joinpoint Regression Program 4.6.0.0软件进行Joinpoint回归分析;采用加权最小二乘法拟合Joinpoint回归模型分析时间变化趋势。计算各时间段内年度变化百分比(APC)、全时段内平均年度变化百分比(AAPC)及其95%CI。结果 2016年中国居民慢性非传染性疾病年龄标化死亡率为459.21/10万,2007-2016年间中国居民慢性非传染性疾病年龄标化死亡率呈现显著下降的趋势,有统计学意义(AAPC=-2.1%,95%CI:-3.2%～-1.1%);农村(AAPC=-3.0%,95%CI:-4.3%～-1.6%)、中部地区(AAPC=-3.0%,95%CI:-3.9%～-2.0%)下降较快;中国居民慢性非传染性疾病死亡构成比呈现上升趋势(AAPC=0.6%,95%CI:0.5%～0.6%)。西部地区上升幅度最大,由2007年的79.84%上升至2016年的86.23%,有统计学意义(AAPC=0.8%,95%CI:0.6%～1.1%)。结论 2007-2016年中国居民慢性非传染性疾病年龄标化死亡率下降、死亡构成比上升,慢性非传染性疾病是影响居民健康的主要疾病。建议加强落实慢性病防控全人群策略,重点关注农村、西部地区居民,进一步加强慢性病的预防与控制。

Objective To analyze the level and component ratio of death caused by chronic non-communicable diseases(NCDs)in China from 2007 to 2016,and to provide the basis for formulating strategy of NCDs control and prevention. Methods The cause-of-death data about NCDs,which were collected from National Mortality Surveillance System,were used to analyze the specific crude mortality rates of different age and areas,age-standardized mortalities and component ratio in China from 2007 to2016. The age-standardized mortality was calculated based on Year 2010 Population Census of China. The data were processed by Excel 2016. The Joinpoint regression model performed by Joinpoint Regression Program 4.6.0.0 software was fitted by the weighted least square method to analyze the trend of time variation. The annual change percentage(APC),the average annual change percentage(AAPC) and 95%CI were calculated. Results In 2016,the age-standardized mortality of NCDs in China was 459.21 per 100 000,which decreased(AAPC=-2.1%,95%CI:-3.2%--1.1%,P<0.05) per year on average from 2007 to 2016. The agestandardized mortality of NCDs in rural area and central part in China decreased rapidly(AAPC=-3.0%,95%CI:-4.3%--1.6%;AAPC=-3.0%,95%CI:-3.9%--2.0%,P<0.05). The component ratio trend of NCDs in Chinese residents increased(AAPC=0.6%,95%CI:0.5%-0.6%),which in western part in China increased at the greatest degree and from 79.84% in 2007 to 86.23%in 2016(AAPC=0.8%,95%CI:0.6%-1.1%,P<0.05). Conclusion The age-standardized mortality of NCDs decreased and the component ratio increased in China from 2007 to 2016,NCDs were the main diseases affecting the health of Chinese residents. It is suggested that "A population strategy" for prevention and control of NCDs should be carried out,especially,residents in rural area and western part in China should be given more attention.