2006-2020年杭州市脑血管病死亡趋势分析

Trends in cerebrovascular disease mortality in Hangzhou City from 2006 to 2020

目的了解2006—2020年杭州市居民脑血管病死亡趋势,为完善脑血管病防控策略提供依据。方法通过杭州市县级及以上医院和社区卫生服务中心(乡镇卫生院)填报的户籍居民死亡卡收集2006—2020年杭州市居民脑血管病死亡资料,采用2010年全国人口普查数据标化;计算年度变化百分比(APC)分析脑血管病粗死亡率和标化死亡率。结果2006—2020年杭州市居民脑血管病死亡109891例,占总死亡人数的17.72%,粗死亡率和标化死亡率分别为105.83/10万和65.15/10万,均呈下降趋势,APC值分别为-0.80%(t=-3.832,P=0.002)和-4.69%(t=-24.084,P<0.001)。2006—2020年出血性脑卒中粗死亡率呈下降趋势,APC值为-7.97%(t=-30.704,P<0.001);缺血性脑卒中和脑血管病后遗症粗死亡率呈上升趋势,APC值分别为5.76%(t=6.106,P<0.001)和13.20%(t=18.103,P<0.001)。男性脑血管病粗死亡率为110.15/10万,高于女性的101.51/10万(χ^(2)=183.078,P<0.001),均呈下降趋势,APC值分别为-0.90%(t=-4.669,P<0.001)和-0.70%(t=-2.658,P=0.020)。城市居民脑血管病粗死亡率为101.95/10万,呈下降趋势,APC值为-1.19%(t=-3.655,P=0.003);农村居民脑血管病粗死亡率为112.46/10万,未见明显变化趋势(t=-0.719,P=0.485)。随年龄增长居民脑血管病粗死亡率呈上升趋势(χ_(趋势)^(2)=502711.682,P<0.001),≥35岁居民脑血管病粗死亡率均呈逐年下降趋势(P<0.05)。结论2006—2020年杭州市居民脑血管病死亡率呈下降趋势;农村居民、男性和老年人脑血管病死亡率较高。

Objective To investigate the trends in cerebrovascular disease mortality among residents in Hangzhou City from 2006 to 2020,so as to provide insights into the development of cerebrovascular disease control strategy.Methods The cerebrovascular disease mortality data were collected from residents in Hangzhou City through household registered death cards recorded in county-and city-level hospitals,township-level health centers and community health service centers in Hangzhou City and standardized by the national population census data in China in 2010.The changes in the crude and standardized mortality of cerebrovascular diseases were estimated using annual percent change(APC)in Hangzhou City from 2006 to 2020.Results A total of 109891 deaths were reported due to cerebrovascular diseases among residents in Hangzhou City from 2006 to 2020,accounting for 17.72%of all deaths in Hangzhou City during the 15-year period,and the crude and standardized mortality rates were 105.83/105 and 65.15/105,which both appeared a tendency towards a decline(crude mortality:APC=-0.80%,t=-3.832,P=0.002;standardized mortality:APC=-4.69%,t=-24.084,P<0.001).The crude mortality of hemorrhagic stroke showed a tendency towards a decline among residents in Hangzhou City from 2006 to 2020(APC=-7.97%,t=-30.704,P<0.001),and the crude mortality of both ischemic stroke(APC=5.76%,t=6.106,P<0.001)and sequelae of cerebrovascular disease(APC=13.20%,t=18.103,P<0.001)appeared a tendency towards a rise.The crude mortality of cerebrovascular diseases was significantly higher in men than in women(110.15/105 vs.101.51/105;χ^(2)=183.078,P<0.001),which both appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020(men:APC=-0.90%,t=-4.669,P<0.001;women:APC=-0.70%,t=-2.658,P=0.020).The crude mortality of cerebrovascular diseases was 101.95/105 and appeared a tendency towards a decline among urban residents in Hangzhou City from 2006 to 2020(APC=-1.19%,t=-3.655,P=0.003),and was 112.46/105 and showed no remarkable changes among rural residents in Hangzhou City from 2006 to 2020(t=-0.719,P=0.485).In addition,the crude mortality of cerebrovascular diseases appeared a tendency towards a rise with age among residents in Hangzhou City from 2006 to 2020(χ_(trend)^(2)=502711.682,P<0.001),and the crude mortality of cerebrovascular diseases appeared a tendency towards a decline among residents at ages of 35 years and above in Hangzhou City from 2006 to 2020(P<0.05).Conclusions The cerebrovascular disease mortality appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020,and a high mortality rate of cerebrovascular diseases was seen among rural residents,men and the elderly.