2014-2020年青岛市急性心肌梗死发病率、死亡率特征及疾病负担分析

Analysis on incidence,mortality and disease burden of acute myocardial infarction in Qingdao,2014-2020

目的描述青岛市2014-2020年急性心肌梗死(AMI)发病、死亡变化趋势以及疾病负担。方法数据来源于青岛市慢性病监测系统,采用Joinpoint对数线性回归模型估算标化发病率、死亡率平均年度变化百分比(AAPC),并计算伤残调整寿命年(DALY)评估疾病负担。结果2014-2020年青岛市共报告AMI发病70491例,标化发病率为54.71/10万;死亡50832例,标化死亡率为36.55/10万。标化发病率的AAPC(95%CI)为2.86%(95%CI:0.42%~5.35%),其中男女性标化发病率AAPC(95%CI)分别为4.30%(95%CI:1.24%~7.45%)和0.78%(95%CI:-0.89%~2.47%)。Joinpoint对数回归模型分析结果显示,30~、40~岁年龄组标化发病率增长速度较快,AAPC(95%CI)分别为8.92%(95%CI:2.23%~16.06%)和6.32%(95%CI:3.30%~9.44%);其中男性各年龄组增长趋势更为明显,30~、40~、50~岁年龄组的AAPC(95%CI)分别为11.25%(95%CI:3.54%~19.54%)、6.73%(95%CI:2.63%~10.99%)和6.72%(95%CI:2.98%~10.60%)。标化死亡率的AAPC无显著变化。DALY率由2014年的7.49/1000上升至2020年的8.61/1000,AAPC为1.97%(95%CI:0.36%~3.60%)。结论青岛市男性2014-2020年AMI标化发病率呈上升趋势,其中30~49岁年龄组标化发病率增长显著。AMI标化死亡率变化相对稳定。男女性疾病负担呈上升趋势。

Objective To describe the characteristics and change trends of incidence,mortality and disease burden of acute myocardial infarction(AMI)in Qingdao from 2014 to 2020.Methods We analyzed the incidence data of AMI retrieved from Qingdao Chronic Diseases Surveillance System.The average annual percent change(AAPC)of morbidity and mortality of AMI were evaluated by using Joinpoint log-linear regression model.Disability adjusted life year(DALY)was used to estimate disease burden of AMI in Qingdao.Results A total of 70491 AMI cases and 50832 deaths of AMI occurred in Qingdao from 2014 to 2020.The age-standardized morbidity and mortality were 54.71/100000 and 36.55/100000,respectively.During 2014-2020,the AAPC of age-standardized morbidity was 2.86%(95%CI:0.42%-5.35%),and 4.30%(95%CI:1.24%-7.45%)in men and 0.78%(95%CI:-0.89%-2.47%)in women,respectively.The log-linear regression model showed that age-standardized morbidity in age groups 30-39,40-49 years increased rapidly,with the AAPCs of 8.92%(95%CI:2.23%-16.06%)and 6.32%(95%CI:3.30%-9.44%),respectively.The trend was also observed in age groups 30-39,40-49 and 50-59 years in men,with the AAPCs of 11.25%(95%CI:3.54%-19.54%),6.73%(95%CI:2.63%-10.99%)and 6.72%(95%CI:2.98%-10.60%),respectively.There was no significant change in age-standardized mortality.The DALY rate increased from 7.49/1000 in 2014 to 8.61/1000 in 2020,with the AAPC of 1.97%(95%CI:0.36%-3.60%).Conclusions The age-standardized morbidity of AMI in men increased in Qingdao,especially in those aged 30-49 years,while age-standardized mortality rate of AMI was relatively stable from 2014 to 2020.The burden of disease of AMI increased in both men and women.