中国居民2013年酒精归因死亡及对期望寿命影响的分析

Deaths attributable to alcohol use and its impact on life expectancy in China, 2013

目的 分析2013年中国居民饮酒归因死亡和期望寿命损失情况。方法 利用2013年中国居民死因监测和中国慢性病及其危险因素监测数据，通过计算人群归因分值估计饮酒造成的死亡及其对期望寿命的影响。结果 2013年中国居民饮酒导致死亡人数为38.12万，同时避免了7.65万人死亡。饮酒导致死亡最多的为出血性脑卒中（9.71万）、肝癌（8.82万）、肝硬化（6.14万）和食道癌（4.87万），避免了6.85万缺血性心脏病、0.49万缺血性脑卒中和0.31万糖尿病可能造成的死亡。饮酒给我国居民造成0.43岁的预期寿命损失。若避免饮酒，西部地区居民获益最多，期望寿命能增加0.52岁，高于东部和中部地区（0.12岁）；农村地区人群期望寿命增加0.48岁，高于城市地区（0.31岁）。结论 尽管饮酒对降低缺血性心脏病和脑卒中以及糖尿病死亡具有一定的保护作用，但总体而言，饮酒仍然是影响中国居民死亡和期望寿命损失的重要危险因素，有必要针对过量饮酒带来的健康问题提出应对措施。

Objective To analyze the deaths attributable to alcohol use and its impact on people＇s life expectancy in China in 2013. Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance （2013） were used. The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction. Results In 2013, alcohol use resulted in 381 200 deaths, including 97 100 hemorrhagic stroke deaths, 88 200 liver cancer deaths, 61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths, and prevented 76 500 deaths, including 68 500, 4 900 and 3 100 deaths which might be caused by ischemic heart disease, hemorrhagic stroke and diabetes respectively. If risk factor of alcohol use is removed, the people＇s life expectancy would rise by an average of 0.43 years, especially in western China by 0.52 years, which was 0.12 years higher than that in eastern and central China, and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively. Conclusions Although alcohol has a protective effect on reducing ischemic heart disease, stroke and diabetes deaths, alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China. It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.