2002—2021年中国农村与城市居民呼吸道结核死亡趋势及年龄-时期-队列分析

The trend of respiratory tuberculosis mortality and the age-periodcohort analysis among rural and urban residents in China from 2002 to 2021

目的分析2002—2021年中国呼吸道结核死亡趋势,探讨年龄、时期、队列效应对呼吸道结核死亡风险的影响。方法收集2003—2022年《中国卫生健康统计年鉴》中5~85岁中国居民呼吸道结核年龄别死亡率数据,采用Joinpoint回归模型分析2002—2021年中国城市、农村居民呼吸道结核死亡率的变化趋势,采用年龄-时期-队列模型分析年龄、时期和队列效应对中国城市、农村居民呼吸道结核死亡风险的影响。结果2002—2021年,城市居民、农村居民,男性、女性的呼吸道结核标化死亡率均呈下降趋势,城市居民、农村居民、城市男性、城市女性、农村男性和农村女性平均年度变化百分比分别为-8.42%(t=-6.29,P<0.01)、-8.39%(t=-6.11,P<0.01)、-7.69%(t=-6.19,P<0.01)、-6.69%(t=-5.19,P<0.05)、-7.69%(t=-5.01,P<0.05)、-7.72%(t=-3.49,P<0.01),差异有统计学意义。年龄-时期-队列分析结果显示,农村居民死亡风险快速上升年龄段和最高峰普遍早于城市居民,男性死亡风险快速上升年龄段和最高峰普遍早于女性(年龄效应);时期效应显示城市居民呈下降趋势;队列效应显示,城市居民和农村居民出生越晚的人发病风险越小。结论我国居民呼吸道结核死亡风险整体逐年降低,年龄、时期和出生队列效应对不同性别和区域(城市与农村)居民死亡风险均有一定程度影响。

Objective To analyze the trends of respiratory tuberculosis mortality in China from 2002 to 2021and explore the effects of age,period,and cohort on the risk of respiratory tuberculosis mortality.Methods Data on age-specific mortality rates of respiratory tuberculosis among Chinese residents aged 5 to 85 from the"China Health Statistics Yearbook"from 2003 to 2022 were collected.The Joinpoint regression model was used to analyze the changes in respiratory tuberculosis mortality rates among urban and rural residents in China from 2002 to 2021.The age-period-cohort model was employed to analyze the effects of age,period,and cohort on the risk of respiratory tuberculosis mortality among urban and rural residents in China.Results From 2002 to 2021,the standardized mortality rates of respiratory tuberculosis decreased among urban and rural residents,males,and females in China,with the average annual percentage changes of-8.42%(t=-6.29,P<0.01),-8.39%(t=-6.11,P<0.01),-7.69%(t=-6.19,P<0.01),-6.69%(t=-5.19,P<0.05),-7.69%(t=-5.01,P<0.05),-7.72%(t=-3.49,P<0.01)for urban residents,urban males,urban females,rural residents,rural males,and rural females.The results of the age-period-cohort analysis showed that the risk of death from tuberculosis increased with age,with a rapid increase in the age range and the highest peak of the risk of death in rural residents generally earlier than in urban areas,and the rapid increase in the age range and the highest peak of the risk of death in male residents generally earlier than in female residents(age effect).The period effect showed a decreasing trend in urban residents.The cohort effect showed that urban and rural residents had a lower risk of morbidity the later they were born.Conclusions From 2002 to 2021,the standardized mortality rate of respiratory tuberculosis in Chinese residents showed an overall downward trend,and the effects of age,time,and birth cohort had a certain degree of impact on the mortality risk of residents of different genders and different regions(urban and rural).