2008~2017年中国居民前五位死因死亡专率趋势性分析

Secular trend of the top 5 causes of death in China from 2008 to 2017

目的:分析2008~2017年中国前五位死因死亡专率变化趋势。方法:基于《中国统计年鉴》数据,采用网格搜索法、排列检验和对数线性回归模型分析中国居民前五位死因死亡专率在2008~2017年间的变化趋势,报告各时段年度变化百分比(APC)和全时段内平均年度变化百分比(AAPC)。结果:中国城市居民前五位死因顺位依次为恶性肿瘤、心脏病、脑血管疾病、呼吸系统疾病、损伤和中毒,农村居民依次为脑血管疾病、恶性肿瘤、心脏病、呼吸系统疾病、损伤和中毒。城市居民心脏病死亡专率在2008~2017年间呈线性上升趋势,其AAPC(95%CI)为1.4%(1.0%~1.8%);女性人群中恶性肿瘤、损伤和中毒死亡专率呈下降趋势,AAPC(95%CI)分别为-1.1%(-1.8%~-0.4%)和-3.4%(-5.1%~-1.7%);男性人群中脑血管疾病、损伤和中毒死亡专率呈上升趋势,AAPC(95%CI)分别为0.8%(0.2%~1.4%)和1.8%(0.1%~3.7%)。农村居民脑血管疾病和心脏病死亡专率在2008~2017年间呈线性上升趋势,AAPC(95%CI)分别为1.4%(0.3%~2.6%)和5.7%(3.8%~7.6%);呼吸系统疾病死亡专率呈线性下降趋势,AAPC(95%CI)为-2.9%(-5.0%~-0.8%)。结论:2008~2017年中国居民的主要死因是慢性非传染性疾病。心脑血管疾病应成为疾病预防和控制重点,尤其是在农村地区。

Aim:To investigate the secular trend of the top 5 causes of death in China during 2008 to 2017.Methods:Data were obtained from the China Statistical Yearbooks(2009-2018)and analyzed by Grid Search Method,Permutation test,and log-linear regression model for annual percent change(APC)and average annual percent change(AAPC).Results:The top 5 causes of death were malignant tumor,heart trouble,cerebrovascular disease,respiratory disease,and trauma and toxicosis in urban areas.And the corresponding causes of death in rural areas were cerebrovascular disease,malignant tumor,heart trouble,respiratory disease,and trauma and toxicosis.In urban areas,the specific death rate of heart trouble had an increasing trend from 2008 to 2017,and its AAPC(95%CI)were 1.4%(1.0%-1.8%);the specific death rates of malignant tumor and trauma and toxicosis in the females decreased with AAPC(95%CI)of-1.1%(-1.8%--0.4%)and-3.4%(-5.1%--1.7%);the specific death rates of cerebrovascular disease and trauma and toxicosis in the males increased with AAPC(95%CI)of 0.8%(0.2%-1.4%)and 1.8%(0.1%-3.7%).In rural areas,the specific death rates of cerebrovascular disease and heart trouble had increasing trend from 2008 to 2017,and AAPC(95%CI)were 1.4%(0.3%-2.6%)and 5.7%(3.8%-7.6%),that of respiratory disease decreased with AAPC(95%CI)of-2.9%(-5.0%--0.8%).Conclusion:Chronic non-communicable diseases were the leading cause of death in China from 2008 to 2017.Cardiovascular and cerebrovascular diseases should be the focus of disease prevention and control,especially in rural areas.