2010-2018年江苏省主要肾脏疾病死亡及寿命损失分析

Mortality and years of life lost caused by major kidney diseases in Jiangsu province,2010–2018

目的分析2010—2018年江苏省因主要肾脏疾病所致死亡及其寿命损失的变化特征,为肾脏疾病的防治提供依据。方法通过全国死因监测系统和公安部门搜集江苏省户籍居民的死亡个案信息和人口数,死亡个案的死亡时间为从2010年1月1日至2018年12月31日,人口数为2009—2018年的年末分性别、分年龄段人口数;使用SPSS 18.0和Joinpoint 4.6软件计算死亡率、标化寿命损失率(YLL率)、平均寿命损失年(YLL)、年龄标化率和其年度变化百分比(APC)等指标以评价疾病负担。结果2010—2018年江苏省全人群、男性和女性因主要肾脏疾病死亡分别为41819、23969和17850例;2010、2018年主要肾脏疾病的死亡率分别为6.17/10万和6.96/10万,标化死亡率显著下降,差异有统计学意义(P<0.05),其APC(95%CI)为-2.75%(-3.72%^-1.78%)。全人群、男性和女性因主要肾脏疾病死亡所致的YLL分别为966493.40年、575115.70年和391377.70年,所致的平均YLL依次为23.11年/人、23.99年/人和21.97年/人;2010、2018年YLL率分别为1.53年/1000人和1.55年/1000人,标化YLL率显著下降,差异有统计学意义(P<0.05),其APC(95%CI)为-2.59%(-3.53%^-1.64%)。主要肾脏疾病的年龄别死亡率和年龄别YLL率在30岁之前均处于较低水平,30岁后随年龄增加而上升,60岁后快速上升。2010—2018年,肾脏肿瘤、肾小球疾病、肾小管-间质疾病和肾衰竭的标化死亡率和标化YLL率分别呈显著上升、无显著变化、无显著变化和显著下降的趋势。结论2010—2018年,江苏省四类主要肾脏疾病合计死亡负担和早死负担均显著下降;男性居民肾脏疾病的死亡负担和早死负担均高于女性;肾脏肿瘤死亡负担和早死负担均显著上升,提示在未来应重视其防治工作。

Objective To understand the mortality and years of life lost(YLL)of major kidney diseases as well as related trends in Jiangsu province between 2010 and 2018,and provide scientific basis for the prevention and control of major kidney diseases in the future.Methods The death case data between January 1,2010,and December 31,2018 and the gender and age specific population data between 2009 and 2018 in Jiangsu were collected from National Death Cause Surveillance System and local public security department respectively.The mortality rate,YLL rate,average YLL,age-standardized mortality rate and its annual percentage change(APC)were calculated by using SPSS(Version18.0)and Joinpoint(Version4.6)to evaluate the level of the disease burden.Results Between 2010 and 2018,the death numbers caused by major kidney diseases in total population,males and females in Jiangsu were 41819,23969 and 17850,respectively,the mortality rates in 2010 and 2018 were 6.17/100000 and 6.96/100000,respectively,the age-standardized mortality rate significantly decreased,the APC(95%CI)was-2.75%(-3.72%--1.78%).The YLLs caused by major kidney diseases in total population,males and females were 966493.40,575115.70 and 391377.70 years,respectively,the related average YLLs were 23.11 years/person,23.99 years/person and 21.97 years/person,respectively;the YLL rates in 2010 and 2018 were 1.53 years per 1000 persons and1.55 years per 1000 persons,respectively,the age-standardized YLL rate significantly decreased,the APC(95%CI)was-2.59%(-3.53%--1.64%).The age-specific mortality rates and age-specific YLL rates of major kidney diseases were all at low levels before the age of 30 years and increased slowly after the age of 30 years,and increased rapidly after the age of 60 years.The age-standardized mortality rate and age-standardized YLL rate of kidney cancer significantly increased,but those of both glomerular disease and tubulointerstitial disease showed no significant changes,and those of renal failure decreased significantly.Conclusion Both the overall death burden and premature death burden of four major kidney diseases in Jiangsu decreased significantly between 2010 and 2018.Both the death burden and early death burden in males were more severe than those in females.Both the death burden and premature death burden of kidney cancer increased,suggesting that more attention need to be paid to its prevention and control in the future.