2013年至2021年山东省滕州市脑出血死亡率的时间趋势

Temporal trend of cerebral hemorrhage mortality rate in Tengzhou, Shandong Province from 2013 to 2021

目的探讨山东省滕州市2013至2021年开展高血压综合防控期间不同特征居民脑出血(intracerebral hemorrhage,ICH)死亡率的时间趋势。方法山东省滕州市在2013至2021年期间开展高血压综合防控,采用2013年1月1日至2021年12月31日山东省滕州市ICH死亡病例监测数据统计ICH死亡率,分析其在不同特征居民中的时间趋势。户籍人口来源于山东省滕州市公安局,以2020年中国第7次人口普查数据计算年龄和性别标化死亡率。死亡率的时间趋势和年龄趋势分析采用Cochran-Armitage趋势检验。结果山东省滕州市2013至2021年ICH总体粗和标化死亡率分别由50.51/10万和63.21/10万降至17.51/10万和16.74/10万(Z=-11.013和-15.426,P均<0.001),年均粗和标化死亡率分别下降12.41%和15.30%。2017年总体粗和标化死亡率较2016年升高成峰,主要归因于男性ICH粗和标化死亡率分别升高32.94%和30.92%(χ2=12.328和15.854,P均<0.005)。ICH粗死亡率随年龄增高而增高,并且随年龄增高随时间变化的下降趋势越来越明显;≥65岁年龄段ICH粗死亡率9年间下降77.94%(Z=-14.065,P<0.001)。2017年男性≥65岁和女性45~54岁年龄段ICH粗死亡率分别较2016年升高31.13%和125.79%(χ2=8.877和5.421,P均<0.05)。2021年城区和农村ICH粗死亡率分别较2013年下降93.22%和46.40%(Z=-13.279和-5.393,P均<0.001),年均分别下降28.56%和7.50%。农村2017年ICH粗死亡率较2016年升高30.54%(χ2=16.086,P<0.001),2018年后ICH粗死亡率开始高于城区(χ2=33.400~67.305,P均<0.001)。结论山东省滕州市ICH死亡率随时间变化呈显著下降趋势,男性死亡率高于女性、农村高于城区,提示应对男性和农村重点关注。

Objective To investigate the temporal trend of the mortality rate of intracerebral hemorrhage(ICH)among residents with different characteristics during the comprehensive prevention and control of hypertension in Tengzhou,Shandong Province from 2013 to 2021.Methods Comprehensive prevention and control of hypertension was conducted in Tengzhou,Shandong Province from 2013 to 2021.ICH mortality rate was calculated from January 1,2013 to December 31,2021.ICH mortality monitoring data from Tengzhou,Shandong Province was used to analyze the temporal trend of ICH mortality among residents with different characteristics.The registered residence population came from the Public Security Bureau of Tengzhou,Shandong Province.The age and gender standardized mortality rate was calculated based on the data of China's seventh population census in 2020.The temporal and age trends of mortality were analyzed using Cochran Armitage Trend Tests.Results From 2013 to 2021,the overall crude and standardized mortality rates of ICH in Tengzhou,Shandong Province decreased from 50.51/100000 and 63.21/100000 to 17.51/100000 and 16.74/100000,respectively(Z=-11.013 and-15.426,P<0.001),with an average annual mortality rate decrease of 12.41%and 15.30%,respectively.The overall crude and standardized mortality rates in 2017 peaked compared to 2016,mainly due to an increase of 32.94%and 30.92%in male ICH crude and standardized mortality rates,respectively(χ2=12.328 and 15.854,P<0.05).The mortality rate of ICH increased with age,and the decreasing trend over time became increasingly evident with age.The mortality rate of ICH in the≥65 year old age group decreased by 77.94%over 9 years(Z=-14.065,P<0.001).In 2017,the mortality rate of ICH in the male age group≥65 years old and female 45-54 years old increased by 31.13%and 125.79%compared to 2016 respectively,there were statistically significant differences(χ2=8.877 and 5.421,P<0.05).In 2021,the mortality rates of urban and rural ICH decreased by 93.22%and 46.40%compared to 2013,respectively(Z=-13.279 and-5.393,P<0.001),with an average annual decrease of 28.56%and 7.50%,respectively.The ICH mortality rate in rural areas increased by 30.54%in 2017 compared to 2016(χ2=16.086,P<0.001);after 2018,the mortality rate of ICH began to be higher than that of urban areas(χ2=33.400 and 67.305,P<0.001).Conclusions The ICH mortality rate in Tengzhou,Shandong Province has shown a significant downward trend over time,with male mortality rate higher than female mortality rate and rural mortality rate higher than urban areas.This suggests that the key attention should be paid to both male and rural areas.