2012—2018年重庆市蛛网膜下腔出血发病和死亡趋势分析

Analysis on incidence and death trend of subretinal hemorrhage in Chongqing city from 2012 to 2018

目的了解重庆市蛛网膜下腔出血发病、死亡趋势变化,为开展蛛网膜下腔出血防治提供建议。方法2012—2018年重庆市蛛网膜下腔出血个案资料来源于中国疾病预防控制中心国家心脑血管事件登记报告系统。据国际疾病分类编码(ICD-10)进行疾病分类,蛛网膜下腔出血编码为I60。采用SPSS 25.0统计软件计算发病率、标化发病率、死亡率、标化死亡率、构成比。不同地区、男女性发病率与死亡率的比较采用χ^2检验。率的趋势变化采用年度变化百分比(APC)分析。结果重庆市蛛网膜下腔出血病发率与标化发病率分别由2012年的7.49/10万、6.45/10万上升至2018年的18.40/10万、14.39/10万,APC分别为19.96%、20.92%,变化趋势有统计学意义(P<0.01)。2012年蛛网膜下腔出血发病率城市高于农村,2015—2018年农村高于城市,差异均有统计学意义(P<0.05,P<0.01)。蛛网膜下腔出血死亡率与标化死亡率分别由2012年的8.56/10万、5.04/10万下降至2018年的5.92/10万、3.53/10万,APC分别为-6.01%、-5.45%,变化趋势均无统计学意义(P>0.05),蛛网膜下腔出血死亡率男性高于女性,农村高于城市,差异均有统计学意义(P<0.05,P<0.01)。城市地区蛛网膜下腔出血死亡率与标化死亡率分别以年均13.15%、13.06%的速度下降,变化趋势均有统计学意义(P<0.01)。结论重庆市蛛网膜下腔出血发病率明显上升,死亡率呈下降趋势,应加强高血压的防治工作,提高农村地区脑卒中救治能力。

Objective To understand the change trend of the incidence and mortality of subretinal hemorrhage in Chongqing,and to provide the suggestion for subretinal hemorrhage prevention and control.Methods The data of subretinal hemorrhage in Chongqing from 2012 to 2018 were from the national reported system of cardiovascular and stroke in Chinese center for disease control and prevention.According to the International Classification of Diseases(ICD-10),the code of subretinal hemorrhage was I60.The software SPSS 25.0 was used to calculate the incidence,age standardization incidence rate(ASIR),mortality and age standardization mortality rate(ASMR)and constituent ratio.χ^2 test was used to compare the incidences and mortalities for different sex and areas.The annual change percent(APC)was used to analyze the change trend of rates.Results The incidence and ASIR of subretinal hemorrhage in Chongqing increased from 7.49/105 and 6.45/105 in 2012 to 18.40/10~5 and 14.39/10~5 in 2018,APCs were 19.96% and 20.92%(P<0.01).The incidence of subretinal hemorrhage in Chongqing during 2012 in urban areas was higher than that in rural areas,but the incidences of subretinal hemorrhage in Chongqing from 2015 to 2018 in rural areas were higher than those in urban areas(P<0.05 or P<0.01).The mortality and ASMR of subretinal hemorrhage reduced from 8.56/105 and 5.04/105 in 2012 to 5.92/105 and 3.53/105 in 2018,APCs were-6.01%and-5.45%,respectively,but P>0.05.The mortalities of subretinal hemorrhage in males and rural areas were significantly higher than those in females and urban areas(P<0.05 or P<0.01).The mortality and ASMR of subretinal hemorrhage yearly reduced by 13.15% and 13.06%(P<0.01).Conclusion The incidence of subretinal hemorrhage increased significantly and the mortality decreased in Chongqing.The hypertension prevention and control should be strengthen and the medical capability of subretinal hemorrhage in rural areas should be enhaneed.