2012—2018年重庆市急性心肌梗死发病死亡趋势分析

Trend analysis of morbidity and mortality of acute myocardial infarction from 2012 to 2018 in Chongqing

目的了解重庆市急性心肌梗死(AMI)发病与死亡流行趋势,为开展AMI防治提供建议。方法2012—2018年重庆市AMI个案资料来源于重庆市心脑血管疾病监测数据库。根据国际疾病分类编码(ICD-10)进行疾病分类,AMI编码为I21-I22。采用SPSS 25.0软件计算发病率、标化发病率、死亡率和标化死亡率。率的比较采用χ^(2)检验,率的趋势变化分析采用年度变化百分比(APC)。结果重庆市AMI发病率与标化发病率分别由2012年的29.86/10万、24.52/10万上升至2018年的52.67/10万、39.56/10万,APC分别为12.41%与11.18%,变化趋势均有统计学意义(P<0.01)。2012—2018年AMI发病率男性均高于女性(P<0.01)。2014年AMI发病率城市高于农村,2015—2018年AMI发病率农村高于城市(P<0.01)。农村地区AMI发病率与标化发病率分别以年均15.37%与14.34%的比例上升,变化趋势均有统计学意义(P<0.01)。2012年重庆市AMI死亡率与标化死亡率分别为20.05/10万、16.37/10万,2018年AMI死亡率与标化死亡率分别为37.49/10万、27.73/10万,变化趋势均无统计学意义(P>0.05)。2012年、2013年与2018年AMI死亡率男性高于女性(P<0.05,P<0.01)。2012年与2013年AMI死亡率城市高于农村,2015年后农村高于城市,差异均有统计学意义(P<0.01)。农村地区AMI死亡率与标化死亡率分别以14.34%、12.41%的比例上升,变化趋势均有统计学意义(P<0.05,P<0.01)。结论重庆市AMI发病率与死亡率较高,并呈快速上升的趋势,男性与农村居民是AMI防治的重点人群。

Objective To understand the trend of morbidity and mortality of acute myocardial infarction(AMI)in Chongqing,and to provide the suggestion for AMI prevention and treatment.Methods The AMI case data in Chongqing from 2012 to 2018 were from the surveillance data of cardiovascular diseases in Chongqing.According to the International Classification of Diseases(ICD-10)code,the code of AMI is I21-I22.The morbidity and standardized morbidity,mortality and standardized mortality were calculated.χ^(2) test was used to analyze the data,the annual change percent(APC)was used to analyze the trend change of the morbidity and mortality of AMI.The used software was SPSS 25.0.Results The morbidity and standardized morbidity of AMI in Chongqing increased from 29.86/105 and 24.52/105 in 2012 to 52.67/105 and 39.56/105 in 2018;APCs were 12.41% and 11.18%(P<0.01).The AMI morbidity of males was significantly higher than that of females from 2012 to 2018(P<0.01).The AMI morbidity of urban area was significantly higher than that of rural area in 2014,after 2015 the AMI morbidity of rural area was significantly higher than that of urban area(P<0.01).The morbidity and standardized morbidity of AMI in rural area increased 15.37% and 14.34% annually,respectively(P<0.01).The mortality and standardized mortality of AMI in Chongqing in 2012 were 20.05/105 and 16.37/105,respectively;the mortality and standardized mortality of AMI in Chongqing in 2018 were 37.49/105 and 27.73/105,respectively;P>0.05.In 2012,2013 and 2018,the AMI mortalities of males were significantly higher than those of females(P<0.05 or P<0.01).The AMI mortalities of urban area were significantly higher than those of rural area in 2012 and 2013,but the AMI mortalities of rural area after 2015 were significantly higher than those of urban area(P<0.01).The AMI mortality and standardized mortality of rural area increased 14.34% and 12.41% annually(P<0.05 or P<0.01).Conclusion The AMI morbidity and mortality of Chongqing are higher.Moreover,the trend of AMI morbidity and mortality increase rapidly.The males and rural residents are crucial population for AMI prevention and treatment.