1990与2015年天津市心脑血管病疾病负担分析

The analysis on the burden of cardiovascular diseases in 1990 and 2015 of Tianjin

目的研究天津市1990与2015年心脑血管病的疾病负担变化情况,为天津市心脑血管疾病防控和管理提供依据。方法利用2015年全球疾病负担(GBD 2015)中国研究结果中的天津市数据,以2000-2025年世界人口的平均人口结构作为标准人口,采用SAS 9.4软件包计算1990和2015年天津市心血管疾病的死亡数、死亡率、早死损失寿命年(YLL)、伤残损失寿命年(YLD)、伤残调整寿命年(DALY)、YLD率、YLL率和DALY率及标化指标,并计算相关指标的变化幅度,对1990和2015年天津市心脑血管疾病死亡情况和疾病负担进行描述。结果 2015年天津市心脑血管疾病的死亡率为223.13/10万,标化死亡率为264.08/10万,其所造成的DALY、YLL和YLD分别为620 066.88、557 793.33和62 273.55人年,标化DALY率、标化YLL率和标化YLD率分别为4 133.32/10万、3 720.06/10万和413.26/10万;与1990年相比,2015年心血管病的死亡数、DALY、YLL和YLD分别增加了60.85%,31.37%,25.61%和122.94%,而标化死亡率、标化DALY率和标化YLL率分别下降了31.13%、41.46%和44.18%,标化YLD率增加4.37%。在不同种类的心血管疾病中,1990年的DALY以出血性脑卒中为最高,其次为缺血性心脏病,分别为169 708.02和155 066.59人年;2015年的DALY以缺血性心脏病为最高,其次为出血性脑卒中,分别为285 781.07和149 732.85人年;与1990年相比,2015年缺血性心脏病和缺血性脑卒中的DALY分别增加了84.30%和47.38%,其中男性增加更多,分别为122.32%和76.63%;风湿性心脏病、高血压性心脏病和出血性脑卒中均有所下降。结论天津市心脑血管疾病导致的疾病负担越来越严重,男性高于女性,其中以缺血性心脏病和缺血性脑卒中最为严重。

Objective To analyze the changes in the burden of cardiovascular diseases in 1990 and 2015 in Tianjin, and provide the basis for the prevention and control of cardiovascular diseases in Tianjin. Methods The Tianjin data of Chinese results of the Global Burden of Diseases Study 2015（GBD 2015） were used to describe the burden of cardiovascular diseases in Tianjin. The average population structure of the world population from 2000 to 2025 served as the standard population to calculated the death numbers, mortalities, years of life lost（YLL）, years lived with disability（YLD）, disability adjusted life years（DALY）, YLD rates,YLL rates and DALY rates or standardization indexes of cardiovascular diseases in Tianjin in 1990 and 2015. The used software was SAS 9.4. The change rates from 1990 to 2015 for all indexes were used to describe the burden of cardiovascular diseases in1990 and 2015 of Tianjin. Results In 2015, the mortality of cardiovascular diseases was 223.13/105 and the age-standardized mortality was 264.08/105, the DALY, YLL and YLD were 620 066.88, 557 793.33 and 62 273.55 person-years, respectively; the standardization DALY rate, YLL rate and YLD rate were 4 133.32/105, 3 720.06/105 and 413.26/105; as compared with 1990, in2015, the death number, DALY, YLL and YLD increased 60.85%, 31.37%, 25.61% and 122.94%, respectively; the standardization mortality, DALY rate and YLL rate decreased 31.13%, 41.46% and 44.18%, respectively; the standardization YLD rate increased 4.37%. In different kinds of cardiovascular diseases, in 1990, the DALY of hemorrhagic stroke and ischemic heart disease（169 708.02 and 155 066.59 person-years） were the highest; in 2015, the DALY of ischemic heart disease and hemorrhagic stroke（285 781.07 and 149 732.85 person-years）were the highest; as compared with 1990, in 2015, the DALY of ischemic heart disease and ischemic stroke increased 84.30% and 47.38%, respectively; the male DALYs of ischemic heart disease and ischemic stroke increased 122.32% and 76.63%, respectively. However, the rheumatic heart disease, hypertensive heart disease and hemorrhagic stroke declined. Conclusion Burden of cardiovascular disease became more and more serious in Tianjin, especially among the male people, of which the ischemic heart disease and ischemic stroke were most serious.