2014年南昌市西湖区居民死亡现状及Fulfillment指数分析研究

Death Status and Fulfillment Index among Community Residents in Xihu District of Nanchang in 2014

目的了解2014年南昌市西湖区居民死亡水平、死因及其特点,为采取适当的疾病防控策略,提高居民的生命健康水平提供科学依据。方法西湖区疾病预防控制中心提供2014年西湖区居民死亡资料和人口数据,按照国际疾病分类第十版（ICD-10）标准对根本死因进行归类。使用死亡率、死因构成比等指标描述居民死亡水平和死因顺位,采用简略寿命表和去死因寿命表计算Fulfillment指数。结果 2014年南昌市西湖区居民共死亡2 428人,粗死亡率为535.40/10万,标化死亡率为463.06/10万。死因顺位前5位依次是：循环系统疾病、肿瘤、呼吸系统疾病、伤害、内分泌与营养和代谢疾病,合计2 210人,占全死因的91.02%。≤14岁居民死因主要是起源于围生期的某些情况及伤害,15~44岁主要是肿瘤及伤害,45~64岁主要是肿瘤和循环系统疾病,≥65岁主要是循环系统疾病、肿瘤和呼吸系统疾病。Fulfillment指数分布：循环系统疾病集中发生在≥65岁,Fulfillment指数为30.00%以上;肿瘤集中发生在20~69岁,Fulfillment指数为18.17%~44.78%;呼吸系统疾病集中发生在≥60岁,Fulfillment指数为9.30%~17.76%;伤害集中发生在10~24岁,在15~19岁Fulfillment指数高达66.66%;内分泌与营养和代谢疾病集中发生在10~14岁,Fulfillment指数为49.99%。循环系统疾病以脑血管疾病、心脏病和高血压为主,合计占循环系统疾病死因的99.01%;肿瘤内部顺位前3位依次为肺癌、肝癌、胃癌,合计占肿瘤死因的56.63%;呼吸系统疾病以慢性阻塞性肺疾病为主,占呼吸系统疾病死因的67.73%;伤害以交通事故、摔倒或跌落为主,合计占伤害死因的65.93%;内分泌与营养和代谢疾病以糖尿病为主,占内分泌与营养和代谢疾病的87.69%。结论慢性非传染性疾病与伤害是影响南昌市西湖区居民健康的主要疾病,建议针对不同年龄组居民,重点干预不同类型疾病,以降低全人群的发病率和死亡率,提高居民健康水平。

Objective To explore the level and causes of death and its characteristics among community residents in Xihu district of Nanchang in 2014,in order to provide a scientific basis for appropriate disease prevention and control strategies and improve the level of life and health. Methods We obtained deaths and population data for community residents in Xihu district in 2014 from Xihu District Center for Disease Control and Prevention. The international classification of diseases（ ICD-10） was adopted to classify the underlying causes of death. Using indicators such as mortality,proportion of deaths,and etc,for descriptive analysis on level and causes of death cis- position. Fulfillment index was calculated based on abridged and cause- eliminated life tables. Results A total of 2 428 deaths occurred among community residents of Xihu district of Nanchang in 2014. The figure translated into a crude mortality rate of 535. 40 /100 000 and a standardized mortality rate of 463. 06 /100 000,respectively. The top 5 causes of death were circulatory diseases, cancer, respiratory diseases, accidents and endocrinology and nutrition and metabolic diseases,which accounted for 2 210 residents deaths. This figure represented 91. 02%of all deaths. The leading cause of death were some certain conditions originating in the perinatal period and accidents in the 0-14 year- old age group,tumors and accidents in the 15- 44 year- old age group,tumors and circulatory diseases in the 45- 64year- old age group, circulatory diseases, tumors and respiratory diseases in the age 65 and older group. Fulfillment index distribution was as follows： circulatory diseases mainly occurred at age 65 and older,Fulfillment index was more than 30. 00%.The occurrence of tumors focused on the age of 20 to 69 year- old,Fulfillment index was 18. 17% to 44. 78%. Respiratory diseases focused on age 60 and older,Fulfillment index was 9. 30% to 17. 76%. Accidents mainly occurred in 10- 24 year- old group,Fulfillment index was up to 66. 66% in the 15- 19 year- old group. Fulfillment index of endocrinology and nutrition and metabolic diseases was up to 49. 99% at the age of 10- 14 year- old. Circulatory diseases mainly included cerebrovascular disease,heart disease and hypertension,which accounted for 99. 01% of all circulatory diseases. As for the tumors,the top 3most frequent malignancies were cancer of lung, liver and gastric, which accounted for 56. 63%. Respiratory diseases were mainly chronic obstructive pulmonary diseases,which accounted for 67. 73%. Accidents were mainly traffic accidents,falls or drops,which accounted for 65. 93%. The diabetes was the most frequent endocrinology and nutrition and metabolic diseases and accounted for 87. 69%. Conclusion Chronic non- communicable diseases and accidents are major conditions that affected the health of residents in Xihu district of Nanchang city. It is suggested to intervene mainly different types of diseases for different population age groups in order to reduce the morbidity and mortality of the whole residents and improve population health.