无锡市2008-2018年主要慢性病过早死亡对期望寿命的影响

Probability of premature mortality caused by four major non-communicable diseases and its impact on life expectancy inWuxi,2008-2018

目的分析无锡市居民2008-2018年主要慢性病过早死亡变化趋势,评估主要慢性病早死概率变化对期望寿命的影响。方法利用无锡死因监测系统收集的2008-2018年户籍人口死亡数据和无锡市公安局人口数据,应用简略寿命表法、Joinpoint回归法、期望寿命贡献分解法,分析恶性肿瘤、心脑血管疾病、慢性呼吸系统疾病、糖尿病4类主要慢性病早死概率变化趋势以及对期望寿命的影响。结果无锡市居民主要慢性病早死概率从2008年的11.25%下降到2018年的9.25%,呈逐年下降趋势(AAPC=-2.0%,95%CI:-2.6~-1.5),女性早死概率较低,且下降速度(由7.74%降至5.91%)快于男性(由14.49%降至12.51%)。2008-2018年无锡市男性和女性期望寿命分别增加了1.86岁(由78.66岁增至80.52岁)和1.26岁(由83.85岁增至85.11岁)。恶性肿瘤、心脑血管疾病、慢性呼吸系统疾病早死概率的降低对期望寿命增长起到"正向贡献",分别使期望寿命增加0.34岁(23.90%)、0.15岁(10.50%)、0.03岁(2.36%),其中40~55岁男性心脑血管疾病过早死亡对期望寿命的增长呈"负向贡献"(-0.04岁)。男性糖尿病早死概率呈上升趋势(AAPC=7.1%,95%CI:2.8~11.6),糖尿病过早死亡对无锡市男性和女性期望寿命均呈"负向贡献",使期望寿命降低0.03岁(-2.14%)。结论2008-2018年无锡市居民主要慢性病早死概率呈持续下降趋势,对期望寿命增长起到积极作用,与女性相比,男性主要慢性病早死概率较高且下降速度较慢,应重点关注男性心脑血管疾病和糖尿病过早死亡对期望寿命的影响。

Objective To analyze the trend of premature death of non-communicable diseases(NCDs)in Wuxi from 2008 to 2018 and evaluate the influence of premature mortality probability caused by four main NCDs on life expectancy.Methods Based on the mortality data collected by Wuxi Mortality Registration System and the population data collected by Wuxi Public Security Bureau during 2008-2018,this study analyzes the trend of the probability of premature death on malignant tumors,cardiovascular and cerebrovascular diseases,chronic respiratory diseases,and diabetes.The impact on life expectancy was analyzed by using the methods of abridged life table,Joinpoint regression,and life expectancy contribution decomposition.Results From 2008 to 2018,the total probability of premature death of four main NCDs in Wuxi were declined consistently from 11.25%to 9.25%(AAPC=-2.0%,95%CI:-2.6--1.5),higher in female(from 7.74%to 5.91%)than that in male(from 14.49%to 12.51%).The Wuxi resident's life expectancy increased by 1.86 years(from 78.66 to 80.52 years),in males and 1.26 years(from 83.85 to 85.11 years)in females,respectively.The decline of premature death of malignant tumors,cardiovascular and cerebrovascular diseases and chronic respiratory system diseases had a positive contribution to life expectancy,which contributed 0.34 years(23.90%),0.15 years(10.50%),and 0.03 years(2.36%)to the life expectancy growth,respectively.Among which,premature death of cardiovascular and cerebrovascular diseases in men aged 40-55y had a negative contribution to life expectancy(-0.04 years).The probability of premature death of males with diabetes was on the rise(AAPC=7.1%,95%CI:2.8-11.6),which negatively contributed to life expectancy for both males and females,reducing life expectancy by 0.03 years(-2.14%)in Wuxi.Conclusion The premature death probability of four main NCDs in Wuxi declined consistently from 2008 to 2018,which played a positive role in the growth of life expectancy.Compared with females,males had a higher premature death probability and a slower rate of decline.More intervention and health management of premature male death on cardiovascular and cerebrovascular diseases and diabetes should be conducted to improve life expectancy further.