山东省滕州市2013—2021年脑出血发病率变化趋势分析

The change trend analysis of incidence of intracerebral hemorrhage in Tengzhou City,Shandong Province from 2013 to 2021

目的分析山东省滕州市2013—2021年开展高血压综合防控(简称高血压防控)9年间,不同特征居民脑出血发病率的变化趋势。方法因滕州市自2013年起开展高血压防控,故采用2013年1月1日至2021年12月31日脑出血新发病例监测数据统计脑出血发病率,并分析其在不同特征居民之间分布的变化趋势。户籍人口信息来源于滕州市公安局,以2020年全国第7次人口普查数据计算年龄和性别标化发病率。发病率的时间趋势和年龄趋势分析采用Cochran-Armitage趋势检验。结果滕州市2013—2021年总体脑出血粗发病率和标化发病率分别由97.30/10万和119.30/10万下降为52.13/10万和50.69/10万(Z=-9.93、-15.40,均P<0.001),两者均在2020年升高成峰,与2019年同比分别升高了22.58%(χ^(2)=24.02,P<0.001)和18.09%(χ^(2)=17.08,P<0.001)。同期男女性发病率变化趋势与总体相似;男性发病率高于女性。脑出血发病率随年龄增加而增高;男性2020年≥45岁3个年龄段与2019年同比升高,差异均有统计学意义[分别增高36.29%、23.57%和16.18%(χ^(2)=6.73、4.65和4.00,均P<0.05)]。城区和农村脑出血发病率分别下降了70.07%和36.23%(Z=18.44、5.22,均P<0.001),但在2020年比2019年分别升高34.15%(χ^(2)=10.88,P<0.01)和22.08%(χ^(2)=18.63,P<0.001)。结论滕州市2013—2021年脑出血发病率呈显著下降趋势,下降幅度女性超过男性;城区超过农村;男性发病似有年轻化趋势。

Objective To analyze the changing trend of intracerebral hemorrhage(ICH)incidence among residents with different characteristics during 9 years of comprehensive hypertension prevention and control(hypertension prevention and control)in Tengzhou from 2013 to 2021.Methods From January 1,2013 to December 31,2021,the new ICH cases collected by the Center for Disease Control and Prevention in Tengzhou City were analyzed to calculate the incidence of ICH,and the trend of its distribution was analyzed among residents with different ages,sexes,and between urban and rural areas.The registered population information came from Tengzhou Public Security Bureau.Age and sex standardized incidence was calculated based on the 7th National Population Census in 2020.The Cochran-Armitage test was used to analyze the time and age trends of the incidence.Results The overall ICH crude and standardized incidence in Tengzhou City decreased from 97.30/100000 to 52.13/100000(Z=-9.93,P<0.001)and 119.30/100000 to 50.69/100000(Z=-15.40,P<0.001)from 2013 to 2021,and both elevated to form a single peak in 2020,with 22.58%(χ^(2)=24.02,P<0.001)and 18.09%(χ^(2)=17.08,P<0.001)higher than in 2019,respectively.The trends in male and female incidence over the same period were similar to the overall trends,and the incidence was higher in males than in females in all years.The incidence of ICH increased with age in all years.The difference of increase in male incidence rate in 2020 was statistically significant in three age groups≥45 years compared with 2019(36.29%,23.57%and 16.18%,respectively,χ^(2)=6.73,4.65,4.00,P<0.001).The incidence of ICH decreased by 70.07%and 36.23%(Z=18.44,5.22,P<0.001)in urban and rural areas respectively from 2013 to 2021,whereas increased by 34.15%(χ^(2)=10.88,P<0.01)and 22.08%(χ^(2)=18.63,P<0.001)in 2020 compared with 2019 separately.Conclusion sThe incidence of ICH in Tengzhou from 2013 to 2021 showed a significant downward trend,with the decrease in the incidence of ICH in women exceeding that in men.The decrease in the incidence of ICH in urban areas exceeded that in rural areas,and male morbidity seemingly had a younger trend.