天津市1999－2015年慢性非传染性疾病过早死亡趋势分析

王德征; 张辉; 徐忠良; 宋桂德; 张颖; 沈成凤; 张爽; 薛晓丹; 王冲; 江国虹

Abstract

王德征,张辉,徐忠良,宋桂德,张颖,沈成凤,张爽,薛晓丹,王冲,江国虹.天津市1999－2015年慢性非传染性疾病过早死亡趋势分析[J].Chinese journal of Epidemiology,2017,38(12):1672-1676

天津市1999－2015年慢性非传染性疾病过早死亡趋势分析

Trend of premature mortality from chronic and non-communicable diseases in Tianjin, 1999-2015

Received:April 18, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.12.018

KeyWord: 慢性非传染性疾病过早死亡趋势

English Key Word: Chronic non-communicable diseases Premature mortality Trend

FundProject:天津市卫生局科技基金（2013KY22）；天津市科技计划项目（15ZLZLZF01140）

Author Name	Affiliation	E-mail
Wang Dezheng	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Zhang Hui	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Xu Zhongliang	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Song Guide	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Zhang Ying	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Shen Chengfeng	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Zhang Shuang	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Xue Xiaodan	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Wang Chong	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China
Jiang Guohong	Tianjin Centers for Diseases Control and Prevention, Tianjin 300011, China	jiangguohongtjcdc@126.com

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Abstract:

目的分析1999-2015年天津市30~69岁居民心脑血管疾病、肿瘤、糖尿病和慢性呼吸系统疾病过早死亡及其变动趋势，探讨其在不同特征人群中的特点并评价危害程度。方法采用天津市CDC收集的居民全死因监测数据，户籍人口信息源自天津市公安局。以2000年世界标准人口计算年龄别、性别标化死亡率，根据WHO推荐的早死概率计算方法统计居民过早死亡概率，采用Joinpoint回归和Cochran-Armitage趋势检验分析17年的变化趋势以及在不同年龄、性别以及城乡之间分布差异。结果 1999-2015年天津市慢性非传染性疾病（慢性病）过早死亡标化死亡率为382.38/10万至250.95/10万，呈逐年下降趋势[年度变化百分比（APC）=-2.41%，P<0.001]，过早死亡概率为19.67%~12.85%，呈逐年下降趋势（APC=-2.49%，P<0.001）。心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病过早死亡概率均呈下降趋势（APC分别为-2.92%、-1.13%、-9.51%和-3.39%，均P<0.001）。男性慢性病过早死亡呈逐年下降趋势，过早死亡概率为22.27%~16.47%（APC=-1.59%，P<0.001）。女性慢性病过早死亡低于男性，过早死亡概率为17.02%~9.17%，也呈逐年下降趋势（APC=-3.84%，P<0.001），下降趋势快于男性。城市居民慢性病过早死亡概率为21.04%~12.34%（APC=-3.26%，P<0.001）；农村居民慢性病过早死亡概率为17.80%~13.54%（APC=-1.54%，P<0.001）。农村居民慢性病过早死亡由原先低于城市逐渐高于城市。结论 1999-2015年天津市居民慢性病过早死亡呈下降趋势，男性、农村居民为过早死亡高发人群。

English Abstract:

Objective To explore the trends and distribution of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory disease and diabetes in different sex and residential areas in Tianjin so as to provide basis for setting up prevention and control programs on premature mortality.Methods Population data on premature mortality in 1999-2015 were from the ‘Tianjin population based mortality surveillance system’ maintained by Tianjin Centers for Disease Control and Prevention (CDC). Data related to permanent residents was from the Tianjin Municipal Public Security Bureau. Standardized premature mortality rates were calculated and adjusted for age and gender according to the ‘2000 world standard population’. Premature mortality probabilities were analyzed according to the methods recommended by WHO. Joinpoint regression and Cochran-Armitage trend methods were used to determine the significance of differences on the trends of mortality.Results From 1999 to 2015, the premature mortality appeared consistent (P<0.001) declining in the above-said four diseases with the APC of probabilities as -2.92%, -1.13%, -9.51% and -3.39%, respectively. The probabilities of premature mortality were all declining consistently in both men and women and in both urban and rural areas in Tianjin. From 1999 to 2015, the probabilities of the four main NCDs were between 19.67% and 12.85% (APC=-2.49%, P<0.001), higher in women (from 17.02% to 9.17%, APC=-3.84%, P<0.001) than that in men (from 22.27% to 16.47%, APC=-1.59%, P<0.001), in urban (from 21.04% to 12.34%, APC=-3.26%, P<0.001) than that in rural areas (from 17.80% to 13.54%, APC=-1.54%, P<0.001).Conclusion Our findings suggested that premature mortality in Tianjin was decreasing during 1999-2015 but attention should still be called for on males and people living in the rural areas to further reducing the premature mortality.

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