2004—2018年中国0~1岁儿童先天性心脏病死亡变化与趋势分析

The analysis on the change and trend of the congenital heart disease mortality rate in children aged 0-1 in China from 2004 to 2018

目的分析2004—2018年0~1岁儿童先天性心脏病死亡水平及变化趋势。方法利用公开出版的2004—2018年中国死因监测数据集的0~1岁先天性心脏病死亡数据,计算不同性别、城乡、地区的先天性心脏病死亡率及构成比;采用Joinpoint回归模型分析死亡率与构成比的变化趋势,计算各时间段内年度变化百分比(APC)、全时段内平均年度变化百分比(AAPC)及其95%CI值。结果2004—2018年0~1岁儿童先天性心脏病死亡共15969例,男童占58.12%(9281例),农村占71.79%(11464例),东、中、西部地区先心病死亡病例分别占34.30%、37.06%和28.64%。2004—2018年0~1岁儿童先天性心脏病死亡率从106.81/10万下降到38.70/10万,年平均下降速度为[AAPC(95%CI)=-7.2%(-11.5%,-2.6%)];女童先天性心脏病亡率[AAPC(95%CI)=-7.7%(-13.0%,-2.0%)]与男童死亡率[AAPC(95%CI)=-6.8%(-12.0%,-1.2%)]均呈下降趋势;城市先天性心脏病死亡率[AAPC(95%CI)=-5.9%(-9.9%,-1.7%)]与农村死亡率[AAPC(95%CI)=-7.4%(-10.5%,-4.2%)]均呈下降趋势;东部地区儿童先天性心脏病死亡率[AAPC(95%CI)=-8.6%(-14.2%,-2.6%)]与中部地区死亡率[AAPC(95%CI)=-7.8%(-11.5%,-4.0%)]呈下降趋势;性别间、城乡间、地区间死亡率差距逐渐缩小;2004—2018年0~1岁儿童先天性心脏病死亡构成比呈上升趋势[AAPC(95%CI)=3.3%(1.7%,4.9%)]。结论2004—2018年0~1岁儿童先天性心脏病死亡率呈下降趋势,构成比呈上升趋势。

Objective To analyze the trend of the congenital heart disease mortality rate in children aged under 1 year old from 2004 to 2018.Methods The mortality rate and constituent ratio of congenital heart disease in different genders,urban and rural areas and regions were calculated by using the publicly available Dataset of National Mortality Surveillance in China from 2004 to 2018.The Joinpoint regression model was used to analyze the changing trend of mortality rate and constituent ratio,and calculate the annual percentage change(APC)in each time period,the average annual percentage change(AAPC)in all time period and their 95%values.Results From 2004 to 2018,a total of 15969 children aged 0 to 1 years died of congenital heart disease,of which 58.12%(9281)were boys and 71.79%(11464)were in rural areas.The deaths of congenital heart disease in eastern,central and western regions accounted for 34.30%,37.06%and 28.64%of total deaths,respectively.From 2004 to 2018,the mortality rate of congenital heart disease in children decreased from 106.81 per 100000 to 38.70 per 100000,with an AAPC(95%)about-7.2%(-11.5%,-2.6%).The mortality rate of congenital heart disease showed a downward trend in girls[AAPC(95%)=-7.7%(-13.0%,-2.0%)],boys[AAPC(95%)=-6.8%(-12.0%,-1.2%)],urban areas[AAPC(95%)=-5.9%(-9.9%,-1.7%)],rural areas[AAPC(95%)=-7.4%(-10.5%,-4.2%)],eastern region[AAPC(95%)=-8.6%(-14.2%,-2.6%)],and central region[AAPC(95%)=-7.8%(-11.5%,-4.0%)].The gaps of mortality rate gradually shrank in different genders,urban and rural areas and regions.From 2004 to 2018,the constituent ratio of congenital heart disease in children showed an upward trend[AAPC(95%)=3.3%(1.7%,4.9%)].Conclusion From 2004 to 2018,the mortality rate of congenital heart disease in children aged 0 to 1 years showed a downward trend,and the constituent ratio showed an upward trend.