1990—2017年中国城市和农村循环系统疾病死亡率变化趋势分析

Trend analysis on the mortality of circulatory system diseases in urban and rural areas in China, 1990-2017

目的探讨近三十年来我国循环系统疾病死亡率变化趋势及其影响因素,应用早死所致的寿命损失年(Years of life lost, YLLs)对1990—2017年中国城市和农村循环系统疾病负担进行综合评价。方法以中国年鉴的数据为基础,采用Joinpoint回归分析计算死亡率年度变化百分比,采用标准方法计算循环系统疾病YLL,根据我国2010年人口普查结果的年龄别构成比对粗死亡率以及YLL率进行标化。结果1990—2017年中国城市和农村居民的循环系统疾病粗死亡率均呈上升趋势,城市标化死亡率有明显下降趋势。1990—2017年,随着年龄的增长,城市和农村居民循环系统疾病的死亡率增加;1990年城市循环系统疾病年龄别死亡率总体上高于农村,而2017年农村循环系统疾病年龄别死亡率已经超过了城市。1990—2017年城市和农村的YLLs分别增长了211.6%和26.1%,城市和农村标化YLL率分别下降了37.9%和12.8%。结论1990—2017年中国城市居民循环系统疾病标化死亡率呈明显下降趋势,而城市和农村居民的循环系统疾病YLLs均增加。

Objective To analyze the trend of mortality rate from circulatory diseases in the last three decades, and evaluate the burden of circulatory diseases from 1990 to 2017 in China′s urban and rural areas by the Years of life lost (YLLs). Methods Data used in this study were obtained from Chinese yearbooks. Joinpoint regression analysis was employed to estimate the annual percent change (APC) of mortality rates from circulatory system diseases. YLLs due to circulatory system diseases were calculated by a standard method. Age-standardized mortality rates and YLL rates were calculated by using a direct method based on the population census in 2010. Results The crude mortality rate of circulatory diseases in urban and rural areas kept on rising from 1990 to 2017, while age-standardized mortality rates of urban residents showed a downward trend. From 1900 to 2017, circulatory mortality of urban and rural residents rose with age. In general, age-specific mortality rate of circulatory diseases among urban residents was higher than that of rural residents in 1990, while the rural age-specific mortality outstripped that of urban residents in 2017. During the study period, YLLs of urban and rural residents increased by 211.6% and 26.1% respectively. However, standardized YLL rates of urban and rural residents decreased by 37.9% and 12.8% respectively. Conclusion From 1990 to 2017, the age-standardized mortality rate of circulatory diseases for urban residents decreased significantly, while the YLLs increased for both urban and rural residents.