2014~2021年襄阳市脑卒中死亡特征及减寿情况分析

Mortality and life lost due to stroke among residents in Xiangyang between 2014 and 2021

目的了解2014~2021年襄阳市居民脑卒中死亡特征与减寿情况。方法以襄阳市居民为研究对象,从襄阳市死因监测系统中提取2014~2021年死因为脑卒中的居民资料进行分析,采用粗死亡率(Crude mortality rate,CMR)、标准化死亡率(Standardized morbidity rate,SMR)、年度变化百分比(Annual percent change,APC)分析脑卒中死亡情况和变化趋势;采用潜在减寿年数(Potential years of life lost,PYLL)、平均减寿年数(Average years of life lost,AYLL)和寿命损失率(Potential years of life lost rate,PYLLR)等指标分析脑卒中疾病负担。结果2014~2021年襄阳市因脑卒中死亡56307人,年均CMR为119.02/10万,SMR为91.76/10万。2014~2021年襄阳市脑卒中的死亡趋势在2018年出现明显拐点,2014~2018年CMR,SMR分别以年10.01%和6.68%的趋势上升(P<0.05),2018~2021年SMR以年10.35%的趋势下降(P<0.05),而CMR则无明显趋势(P>0.05)。2014~2021年襄阳市居民脑卒中PYLL,AYLL和PYLLR分别为332212人年、5.9年和7.02‰。2014~2017年PYLL和PYLLR分别以年8.57%和8.66%的趋势上升,2017~2021年则以年7.37%和年7.15%的趋势下降(P<0.05)。2014~2021年AYLL以年平均3.37%的速度持续下降。2014~2021年脑出血SMR年平均下降3.31%,其中2018~2021年的年平均下降12.65%(P<0.05)。2014~2021年脑梗死的SMR以年平均4.56%的趋势上升,其中2014~2019年的年平均上升11.71%(P<0.05)。2014~2021年脑梗死的CMR则以7.74%的趋势上升(P<0.05),其中2014~2019年的年平均上升15.20%(P<0.05)。2014~2021年襄阳市蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)的CMR,SMR则分别以年平均10.15%、12.25%的趋势逐年下降(P<0.05)。结论襄阳市脑卒中死亡率依然在较高水平,但近年来脑卒中的标化死亡率和寿命损失呈现下降趋势,但脑梗死的死亡率下降趋势仍不明显。

Objective To explore the epidemiological characteristics and life lost due to stroke among residents in Xiangyang from 2014 to 2021.Methods The crude mortality rate(CMR),standardized mortality rate(SMR),and annual percent change(APC)of stroke were obtained by statistical treatment of all death monitoring data of the residents.Indicators of life loss included potential years of life loss(PYLL),potential years of life loss rate(PYLLR),average years of life loss(AYLL)were calculated to analyze the disease burden of stroke.Results From 2014 to 2021,56,307 people died of stroke in Xiangyang City,with an average annual CMR of 119.02/100,000 and SMR of 91.76/100,000.From 2014 to 2021,the death trend of stroke in Xiangyang City showed an obvious inflection point in 2018.From 2014 to 2018,CMR and SMR increased by 10.01%and 6.68%per year respectively(P<0.05).From 2018 to 2021,the SMR decreased with an annual trend of 10.35%,while the CMR kept stable(P>0.05).During 2014-2021,PYLL of stroke was 332212 years,PYLLR was 7.02‰and AYLL was 5.9 years per person.From 2014 to 2017,PYLL and PYLLR increased by 8.57%and 8.66%per year,respectively,and decreased by 7.37%and 7.15%per year from 2017 to 2021(P<0.05).From 2014 to 2021,AYLL will continue to decline at an average annual rate of 3.37%(P<0.05).From 2014 to 2021,the average annual decrease in SMR of cerebral hemorrhage was 3.31%,and from 2018 to 2021,the average annual decrease was 12.65%.The SMR of cerebral infarction increased at an average annual rate of 4.56%from 2014 to 2021,and an average annual increase of 11.71%from 2014 to 2019.The CMR of cerebral infarction increased by 7.74%from 2014 to 2021,with an average annual increase of 15.20%from 2014 to 2019.From 2014 to 2021,the CMR and SMR of subarachnoid hemorrhage in Xiangyang City decreased year by year with an average annual trend of 10.15%and 12.25%respectively.Conclusion The mortality rate of stroke in Xiangyang City is still at a high level,but the standardized mortality rate and life loss of stroke show a downward trend in recent years,but the mortality rate of cerebral infarction showed no significant decline.To reduce stroke mortality,comprehensive prevention and control measures should be taken.