2014—2020年杭州市居民脑卒中发病及死亡变化趋势分析

Trend analysis on the morbidity and mortality of stroke among residents in Hangzhou from 2014 to 2020

目的分析2014—2020年杭州市居民脑卒中发病及死亡变化趋势,为脑卒中综合防治决策的制定和效果评估提供科学依据。方法利用2014—2020年杭州市慢性病监测管理系统收集的脑卒中发病与死亡监测数据,对脑卒中的发病率、死亡率、人群特征及年度变化趋势进行统计分析。以2010年全国第六次人口普查为标准人口计算脑卒中的标化发病率、死亡率。应用Joinpoint软件对脑卒中发病、死亡的变化进行趋势性检验。结果2014—2020年杭州市居民脑卒中的年均粗发病率为335.47/10万,标化发病率为209.15/10万;脑卒中年均粗死亡率为68.16/10万,标化死亡率为36.86/10万。脑卒中男女标化发病比为1.22∶1,标化死亡比为1.04∶1。2014—2020年杭州市脑卒中标化发病率无明显年度变化趋势,年度平均变化百分比(annual avearge percentage change,AAPC)为-0.88%(t=-0.96,P=0.381);标化死亡率呈下降趋势,AAPC为-10.94%(t=-15.37,P=0.001)。脑卒中的发病率和死亡率均呈现随年龄增长增加。但2014—2020年55~<65及≥65岁人群脑卒中死亡率呈现逐年下降趋势,AAPC分别为-10.56%(t=-7.25,P=0.001)、-12.02%(t=-14.09,P<0.01)。缺血性脑卒中是杭州居民最主要的脑卒中发病和死亡类型,占发病总数的80.70%、死亡总数的42.73%。结论2014—2020年杭州市出血性脑卒中和分类不明的脑卒中的发病率和死亡率均呈逐年下降趋势。杭州市居民的脑卒中防控形势依然严峻,需要动员全社会力量共同参与,控制脑卒中发病风险,降低脑卒中危害。

Objective To analyze the morbidity and mortality trend of stroke among residents in Hangzhou during 2014 and 2020,and to provide scientific evidence for the decision-making and effect evaluation of stroke prevention and control strategies.Methods Monitoring data of the morbidity and mortality of stroke among residents in Hangzhou from 2014 to 2020 were retrieved from Hangzhou Chronic Disease Monitoring and Management System.The incidence and death rate of stroke as well as its distribution and dynamic change were analyzed.The incidence and death rate of stroke were standardized based on the population obtained in the sixth national census in 2010.The Joinpoint software was applied to analyze the morbidity and mortality trend of stroke.Results There were 175591 newly diagnosed cases of stroke in Hangzhou during 2014 and 2020 with the annual average crude incidence rate of 335.47 per 100000 and standardized incidence of 209.15 per 100000.A total of 34784 cases died from stroke,with the annual average crude mortality rate and standardized mortality rate of 68.16 and 36.86 per 100000,respectively.The male to female ratio was 1.22:1 in standardized morbidity rate and was 1.04:1 in standardized mortality rate.There was no significant change in the standardized incidence of stroke in Hangzhou from 2014 to 2020 with the average annual percent change(AAPC)of−0.88%(t=−0.96,P=0.381),while the age-standardized mortality decreased significantly with the AAPC of−10.94%(t=−15.37,P=0.001).The age-specific morbidity and mortality of stroke increased with age.However,from 2014 to 2020,the mortality rates of stroke among residents aged 55-65 years and over 65 years showed obvious downward trends with the AAPC of−10.56%(t=−7.25,P=0.001)and−12.02%(t=−14.09,P<0.01),respectively.Ischemic stroke was the most common type of stroke,accounting for 80.70%of total stroke cases and 42.73%of deaths in Hangzhou residents.Conclusions Both morbidity and mortality of hemorrhagic stroke and unclassified stroke show significant downward trends between 2014 and 2020.However,residents in Hangzhou still face a great challenge in fighting with stroke.The whole society should work together to control the risk of stroke and reduce the burden of stroke.