2002-2016年中国呼吸系统疾病死亡率及其变化趋势

Level and trend of respiratory diseases mortality in China from 2002 to 2016

目的分析中国居民2002—2016年呼吸系统疾病的死亡率及其变化趋势。方法使用国家卫生健康委员会统计信息中心发布的2003—2012年中国卫生统计年鉴和2013—2017年中国卫生和计划生育统计年鉴数据,利用2002—2016年的呼吸系统疾病死亡率数据计算标化死亡率,应用Joinpoint模型计算标化死亡率的的年度变化百分比(APC)和平均年度变化百分比(AAPC)。结果2002—2016年我国呼吸系统疾病标化死亡率呈下降趋势(AAPC=-3.6%,P<0.001),其中慢性下呼吸道疾病标化死亡率下降(AAPC=-6.4%,P<0.001),肺癌标化死亡率上升(AAPC=1.6%,P=0.001),肺炎和尘肺标化死亡率变化趋势无统计学意义(分别为APCC=1.0%,P=0.242;APCC=-0.2%,P=0.905)。城市和农村呼吸系统疾病标化死亡率均呈下降趋势(分别为AAPC=-2.9%,P=0.001;AAPC=-4.2%,P<0.001),城市与农村肺癌标化死亡率及城市肺炎标化死亡率均呈现上升趋势(分别为AAPC=0.6%,P=0.022;AAPC=2.1%,P=0.003;AAPC=2.7%,P=0.017)。呼吸系统疾病各年龄段(<35、35~65及≥65岁)标化死亡率均呈下降趋势(分别为AAPC=-3.8%,P=0.001;AAPC=-2.6%,P<0.001;AAPC=-3.9%,P<0.001),35~65岁肺炎标化死亡率和≥65岁居民肺癌标化死亡率呈上升趋势(分别为AAPC=2.8%,P=0.001;AAPC=2.4%,P<0.001)。男性和女性呼吸系统疾病标化死亡率均呈下降趋势(分别为AAPC=-3.1%,P<0.001;AAPC=-4.3%,P<0.001),男性与女性肺癌标化死亡率呈上升趋势(分别为AAPC=1.2%,P<0.001;AAPC=2.5%,P<0.001),男性肺炎、尘肺和女性肺炎标化死亡率变化趋势均无统计学意义(分别为AAPC=1.5%,P=0.096;AAPC=-1.6%,P=0.218;AAPC=-0.1%,P=0.872)。结论2002—2016年我国呼吸系统疾病标化死亡率总体呈下降趋势,总体标化死亡率与主要病种标化死亡率的变化存在地区、年龄与性别的差异。

Objective To analyze the level and trend of respiratory disease mortality in China from 2002 to 2016.Methods The standardized mortality rates were calculated based on the China health statistics yearbook(2003-2012)and China statistical yearbook of health and family planning(2013-2017)data released by the statistical information center of National health Commission of the People′s Republic of China.Joinpoint model was used to calculate the standardized mortality rates(SMR),Annual percentage change(APC)and the average annual percentage change(AAPC)for standardized mortality rates.Results The SMR of respiratory diseases and chronic lower respiratory diseases were decreased significantly in 2002 to 2016(AAPC=-3.6%,AAPC=-6.4%,P<0.001,respectively).The SMR of lung cancer showed a significant increase trend(AAPC=1.6%,P=0.001).There were no significant differences in the SMR of pneumonia and pneumonoconiosis(APCC=1.0%,P=0.242;APCC=-0.2%,P=0.905).Both urban and rural SMR of respiratory diseases were declining significantly(AAPC=-2.9%,P=0.001;AAPC=-4.2%,P<0.001).Both urban and rural SMR of lung cancer showed an increasing trend(AAPC=0.6%,P=0.022;AAPC=2.1%,P=0.003,respectively).The SMR of pneumonia in urban areas showed an upward trend(AAPC=2.7%,P=0.017).The SMR of respiratory disease of all age groups(<35 years old,35-65 years old and≥65 years old)showed a downward trend(AAPC=-3.8%,P=0.001;AAPC=-2.6%,P<0.001;AAPC=-3.9%,P<0.001).The SMR of pneumonia between 35 and 65 years old and SMR of lung cancer over 65 years old showed an increasing trend(AAPC=2.8%,P=0.001;AAPC=2.4%,P<0.001).The SMR of respiratory diseases among males and females showed a downtrend(AAPC=-3.1%,P<0.001;AAPC=-4.3%,P<0.001).However,the SMR of lung cancer in males and females increased significantly(AAPC=1.2%,P<0.001;AAPC=2.5%,P<0.001,respectively).There were no significant trends in the SMR of pneumonia and pneumoconiosis in males(AAPC=1.5%,P=0.096;AAPC=-1.6%,P=0.218).There was no obvious trend in the SMR of pneumonia in females(AAPC=-0.1%,P=0.872).Conclusions The SMR of respiratory diseases in China generally shows a downward trend.The overall SMR and SMR of major respiratory diseases varies among different regions,genders and age groups.