2005—2014年上海市闵行区脑卒中死亡流行病学特征及时间趋势分析

Epidemiological Characteristics and Temporal Trends of Stroke Mortality in Minhang District of Shanghai, 2005-2014

目的分析2005—2014年上海市闵行区脑卒中死亡的流行病学特征和时间变化趋势,为脑卒中的防治提供可靠的基础信息和科学依据。方法计算2005—2014年总人群、男性和女性脑卒中的粗死亡率、标化死亡率和年龄别死亡专率,以及不同类型、不同季节脑卒中的标化死亡率。应用U检验进行年龄别死亡专率之间的比较。采用时间趋势分析APC(annual percent change,年度变化百分比)法描述脑卒中死亡的变化趋势。结果 2005—2014年,全人群、男性和女性的脑卒中粗死亡率和标化死亡率均呈现下降趋势(P<0.05)。男性年平均标化死亡率是女性的1.13倍。全人群中除50岁~59岁组外,其他年龄组死亡专率均呈下降趋势(P<0.05)。男性在30岁~79岁各年龄组的年均死亡专率均显著大于女性(P<0.01)。闵行区脑卒中死亡以缺血性脑卒中为主。全人群和女性出血性脑卒中的标化死亡率呈下降趋势(P<0.05)。各季节脑卒中标化死亡率均呈下降趋势(P<0.05),冬季是脑卒中死亡的高发季节。结论近10年,闵行区脑卒中死亡率呈下降趋势,可能与政策的推动和迅速发展的社区慢性病管理体系有关,建议进一步应用信息化技术,实现对居民健康的精细化管理,有针对性地加强健康教育,提高人群的健康意识。

Objective To analyze epidemiological characteristics and temporal trends of stroke mortality in Minhang District of Shanghai in 2005-2014, to provide reliable information and scientific basis for the prevention and treatment of stroke. Methods Epidemiological indicators of stroke in 2005-2014 were calculated including the crude death rate(CDR), standardized mortality rate(SMR), age specific mortality rate(ASMR) respectively, and SMR by different types and seasons for total male and female populations. The comparisons between ASMRs were made using U test, and temporal trends of stroke mortality were analyzed using Annual Percent Change(APC). Results In 2005-2014, the CDR and SMR of stroke among total male and female populations were decreased(P<0.05). Average SMR of male was 1.13 times more than that of female, and ASMRs of all age groups were decreased except the 50-59 age group(P<0.05). Average ASMR of males of 30-79 age groups was significantly higher than that of the females(P<0.01). The main type of stroke mortality was ischemic stroke, while the SMRs of hemorrhagic stroke among total and female population declined(P<0.05). The SMR of different seasons were decreased(P<0.05), and stroke mortality was especially high in winter. Conclusion the stroke CDR showed a declining trend in the past 10 years in Minhang District regarding probably due to policy driven and fast development of community chronic disease management system. This study recommends further application of information technology, implementation of Fine Management the health of community residents, as well as specifically strengthening health education and health awareness for a targeted population.