Analysis on major chronic diseases on the probability of premature death in Shaanxi Province, 2015-2020
-
摘要:
目的 分析2015—2020年陕西省4类主要慢性非传染性疾病(心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病，简称慢性病)的死亡情况、早死概率、变化趋势，以及预测陕西省“健康中国2030”主要慢性病早死概率目标的实现情况。 方法 利用2015—2020年陕西省死因监测数据，计算粗死亡率、标化死亡率、构成比、早死概率、平均增长速度、早死概率预测值、早死概率目标值，死亡率的比较采用χ2检验，变化趋势的分析采用年度变化百分比(annual percentage change, APC)。 结果 2015—2020年，陕西省4类主要慢性病死亡数占总死亡数比例均达到83.00%以上，占慢性病死亡数比例均达到94.00%以上; 总人群、男性和女性的4类主要慢性病粗死亡率均呈上升趋势(总人群APC=2.02%、男性APC=2.12%、女性APC=1.92%)，标化死亡率均呈下降趋势(总人群APC=-2.96%、男性APC=-2.47%、女性APC=-3.54%)，趋势性χ2检验均有统计学意义(均有P＜0.05);历年男性4类主要慢性病粗死亡率均高于女性，差异均有统计学意义(均有P＜00.001)。2015—2020年陕西省总人群、男性和女性4类主要慢性病早死概率呈下降趋势(总人群APC=-1.78%、男性APC=-1.19%、女性APC=-3.05%)，趋势性χ2检验均有统计学意义(均有P＜00.05);6年间陕西省总人群、男性和女性早死概率分别以1.98%、1.34%、3.43%的速度下降，根据下降速率预测，到2030年，除女性外，陕西省总人群、男性早死概率均无法达到“健康中国2030”早死概率的目标值。 结论 2015—2020年陕西省4类主要慢性病标化死亡率和早死概率均呈下降趋势，但总人群和男性早死概率无法实现目标值，建议进一步加强慢性病综合防治，采取有针对性的干预措施，促进“健康中国2030”目标的实现。 Abstract:Objective The study aimed to analyze the mortality, probability of premature death and change trend of four major chronic diseases (cardiovascular and cerebrovascular diseases, malignant tumors, chronic respiratory diseases and diabetes) in Shaanxi Province from 2015 to 2020, and predicting the realization of the goal of "Healthy China 2030" for major chronic diseases on probability of premature death. Methods Using the monitoring data of death causes in Shaanxi Province from 2015 to 2020, the crude mortality rate, standardized mortality rate, constituent ratio, probability of early death, average growth rate, predicted value of probability of early death and target value of probability of early death were calculated. χ2 test was used for comparison of mortality rates, and annual percentage change (APC) was used for analysis of trends. Results From 2015 to 2020, the death rate of four major chronic diseases accounted for more than 83.00% of the total death rate and more than 94.00% of the death rate of chronic diseases in Shaanxi Province. The crude mortality of the four major chronic diseases in the total population, male and female subgroup showed an upward trend (APC=2.02%, male APC=2.12%, female APC=1.92%), and the standardized mortality showed a downward trend (APC=-2.96%, male APC=-2.47%, female APC=-3.54%), with statistical significance (all P < 0.05). The crude mortality of four major chronic diseases in male was higher than that in female over the years, with statistical significance (all P < 0.001). From 2015 to 2020, the probability of premature death of four major chronic diseases in the total population, male and female showed a decreasing trend (total population APC=-1.78%, male APC=-1.19%, female APC=-3.05%), and the trend test showed statistical significance (all P < 0.05). In the past 6 years, the probability of premature death of the total population, male and female in Shaanxi Province decreased by 1.98%, 1.34% and 3.43%, respectively. According to the prediction of the decline rate, the probability of premature death of the total population and male in Shaanxi Province will not reach the target value of "Healthy China 2030" by 2030, but female can reach the target. Conclusions From 2015 to 2020, the standardized mortality rate and the probability of premature death of four major chronic diseases in Shaanxi Province had declined. The probability of premature death of the total population and male cannot achieve the target value. It is suggested to further strengthen the comprehensive prevention and control of chronic diseases, targeted intervention measures, to promote "Healthy China 2030" goal. -
Key words:
- Major chronic diseases /
- Mortality rate /
- Probability of premature death
-
表 1 2015—2020年陕西省4类主要慢性病死亡构成情况(%)
Table 1. Death composition of four types of chronic diseases in Shaanxi Province from 2015 to 2020 (%)
类别 2015年 2016年 2017年 2018年 2019年 2020年 APC(%) t值 P值 男性 4类主要慢性病死亡占慢性病死亡的比例 93.97 94.28 94.68 94.93 94.72 94.06 0.10 0.57 0.597 4类主要慢性病死亡占总死亡的比例 81.73 82.21 82.66 84.40 84.64 84.83 0.80 6.83 0.002 女性 4类主要慢性病死亡占慢性病死亡的比例 94.25 94.44 94.63 94.88 94.06 94.13 0.00 -0.53 0.628 4类主要慢性病死亡占总死亡的比例 86.20 86.51 87.04 87.89 87.01 87.61 0.30 2.57 0.062 总人群 4类主要慢性病死亡占慢性病死亡的比例 94.09 94.35 94.66 94.91 94.44 94.09 0.00 0.17 0.871 4类主要慢性病死亡占总死亡的比例 83.59 84.00 84.48 85.83 85.63 85.99 0.60 5.98 0.004 
下载: 导出CSV
表 2 2015—2020年陕西省4类主要慢性病分性别死亡情况(/10万)
Table 2. Death of four types of chronic diseases by sex in Shaanxi Province from 2015 to 2020 (/105)
类别 2015年 2016年 2017年 2018年 2019年 2020年 APC(%) t值 P值 男性 死亡数 15 660 16 068 15 454 16 897 16 883 16 949 死亡率 572.49 584.15 581.67 631.27 625.18 625.87 2.12 3.77 0.020 标化率 574.94 540.86 543.42 556.60 518.03 492.93 -2.47 -3.38 0.028 女性 死亡数 11 790 12 084 11 543 12 283 12 514 12 505 死亡率 455.74 463.34 458.44 481.99 495.62 493.66 1.92 4.88 0.008 标化率 498.32 462.73 467.33 459.23 437.42 402.19 -3.54 -5.11 0.007 总人群 死亡数 27 450 28 152 26 997 29 180 29 397 29 454 死亡率 515.74 525.36 521.71 558.46 562.58 561.97 2.02 4.5 0.011 标化率 538.25 503.36 506.74 509.73 479.65 448.73 -2.96 -4.22 0.014
下载: 导出CSV
表 3 2015—2020年陕西省4类主要慢性病分病种死亡情况及变化趋势(/10万)
Table 3. Deaths of four types of chronic diseases and their changing trends in Shaanxi Province from 2015 to 2020 (/105)
类别 2015年 2016年 2017年 2018年 2019年 2020年 APC(%) t值 P值 心脑血管疾病 粗死亡率 335.65 340.16 330.70 353.66 359.86 372.78 2.22 3.82 0.019 标化死亡率 356.06 329.28 325.58 325.23 310.63 298.99 -2.96 -6.09 0.004 恶性肿瘤 粗死亡率 127.16 128.24 133.73 144.23 145.06 138.90 2.53 2.98 0.041 标化死亡率 125.62 118.63 124.43 128.79 119.36 109.37 -1.78 -1.46 0.219 慢性呼吸系统疾病 粗死亡率 39.76 42.04 42.69 43.98 38.62 30.85 -4.21 -1.58 0.19 标化死亡率 43.21 41.60 42.96 40.87 33.70 24.90 -9.34 -3.18 0.033 糖尿病 粗死亡率 13.17 14.91 14.59 16.59 19.04 19.44 8.33 7.61 0.002 标化死亡率 13.35 13.84 13.78 14.84 15.96 15.47 3.56 4.93 0.008
下载: 导出CSV
表 4 2015—2020年陕西省4类主要慢性病分性别、分病种早死概率及变化趋势(%)
Table 4. Premature death probability and change trend of four types of chronic diseases in Shaanxi Province from 2015 to 2020 (%)
类别 2015年 2016年 2017年 2018年 2019年 2020年 APC(%) t值 P值 男性 23.19 22.36 23.09 22.34 21.88 21.68 -1.19 -3.21 0.033 心脑血管疾病 13.65 13.12 12.96 12.42 11.96 12.59 -2.08 -3.08 0.037 恶性肿瘤 9.20 8.74 9.51 9.34 9.36 8.77 -0.10 -0.16 0.884 慢性呼吸系统疾病 1.41 1.33 1.55 1.35 1.21 0.92 -7.04 -2.33 0.081 糖尿病 0.62 0.75 0.80 0.85 0.90 0.87 6.82 4.16 0.014 女性 13.67 13.07 13.07 12.16 12.44 11.48 -3.05 -5.44 0.006 心脑血管疾病 8.15 7.76 7.48 6.82 6.79 6.69 -4.11 -7.10 0.002 恶性肿瘤 5.00 4.72 5.02 4.78 4.97 4.25 -1.98 -1.50 0.209 慢性呼吸系统疾病 0.55 0.51 0.49 0.49 0.49 0.33 -7.32 -2.62 0.059 糖尿病 0.52 0.58 0.59 0.50 0.66 0.59 2.43 1.03 0.362 总人群 18.58 17.87 18.26 17.43 17.36 16.81 -1.78 -4.29 0.008 心脑血管疾病 10.96 10.51 10.29 9.69 9.46 9.74 -2.76 -4.53 0.011 恶性肿瘤 7.12 6.74 7.29 7.09 7.21 6.57 -0.70 -0.62 0.569 慢性呼吸系统疾病 0.98 0.92 1.02 0.92 0.85 0.62 -7.23 -2.52 0.065 糖尿病 0.57 0.67 0.70 0.68 0.79 0.74 5.23 3.33 0.029
下载: 导出CSV
表 5 2015—2020年陕西省4类主要慢性病早死概率平均变化速度、2030年预测值及目标值(%)
Table 5. The average change rate, predicted value and target value of the early death probability of four types of chronic diseases in Shaanxi Province from 2015 to 2020 (%)
类别 2015年 2020年 2015—2020年平均增长速度 2030年早死概率预测值 “健康中国2030”早死概率目标值[4] 男性 23.19 21.68 -1.34 18.95 16.23 心脑血管疾病 13.65 12.59 -1.60 10.71 9.56 恶性肿瘤 9.20 8.77 -0.95 7.97 6.44 慢性呼吸系统疾病 1.41 0.92 -8.18 0.39 0.99 糖尿病 0.62 0.87 7.01 1.71 0.43 女性 13.67 11.48 -3.43 8.10 9.57 心脑血管疾病 8.15 6.69 -3.87 4.51 5.71 恶性肿瘤 5.00 4.25 -3.20 3.07 3.50 慢性呼吸系统疾病 0.55 0.33 -9.71 0.12 0.39 糖尿病 0.52 0.59 2.56 0.76 0.36 总人群 18.58 16.81 -1.98 13.76 13.01 心脑血管疾病 10.96 9.74 -2.33 7.69 7.67 恶性肿瘤 7.12 6.57 -1.60 5.59 4.98 慢性呼吸系统疾病 0.98 0.62 -8.75 0.25 0.69 糖尿病 0.57 0.74 5.36 1.25 0.40
下载: 导出CSV
-
[1] WHO. Global status report on noncommunicable diseases 2014[EB/OL]. (2016-08-09). http://www.who.int/nmh/publications/ncd-status-report-2014/en/. [2] 国家卫生计生委疾病预防控制局. 中国居民营养与慢性病状况报告(2015年)[M]. 北京: 人民卫生出版社, 2016: 48-50.National Health and Family Planning Commission Bureau for Disease Control and Prevention. A report on nutrition and chronic diseases in China (2015)[M]. Beijing: People's Medical Publishing House, 2016: 48-50. [3] Bonita R, Magnusson R, Bovet P, et al. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach[J]. Lancet, 2013, 381(9866): 575-584. DOI: 10.1016/S0140-6736(12)61993-X. [4] 黄莉莉, 蔡志成, 张瀚中, 等. 2014—2018年中山市居民主要慢性病早死概率及变化趋势分析[J]. 热带医学杂志, 2020, 20(6): 843-846, 856. https://www.cnki.com.cn/Article/CJFDTOTAL-RDYZ202006030.htmHuang LL, Cai ZC, Zhang HZ, et al. Premature mortality and trend analysis of major chronic diseases among Zhongshan residents from 2014 to 2018[J]. J Trop Med, 2020, 20(6): 843-846, 856. https://www.cnki.com.cn/Article/CJFDTOTAL-RDYZ202006030.htm [5] 王德征, 张辉, 徐忠良, 等. 天津市1999—2015年慢性非传染性疾病过早死亡趋势分析[J]. 中华流行病学杂志, 2017, 38(12): 1672-1676. DOI: 10.3760/cma.j.issn.0254-6450.2017.12.018.Wang DZ, Zhang H, Xu ZL, et al. Trend of premature mortality from chronic and non-communicable diseases in Tianjin, 1999-2015[J]. Chin J Epidemiol, 2017, 38(12): 1672-1676. DOI: 10.3760/cma.j.issn.0254-6450.2017.12.018 [6] 李刚, 苏健婷, 韦再华, 等. 北京市2010—2015年慢性非传染性疾病早死概率研究[J]. 中华流行病学杂志, 2016, 37(9): 1268-1271. DOI: 10.3760/cma.j.issn.0254-6450.2016.09.017.Li G, Su JT, Wei ZH, et al. Probability of premature mortality caused by non-communicable diseases in Beijing, 2010-2015[J]. Chin J Epidemiol, 2016, 37(9): 1268-1271. DOI: 10.3760/cma.j.issn.0254-6450.2016.09.017. [7] 孟军, 毛玮, 黄金梅. 2008—2017年广西死因监测点四种主要慢性病死亡及早死概率分析[J]. 应用预防医学, 2018, 24(5): 343-348. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX201805004.htmMeng J, Mao W, Huang JM. Death and probability of premature mortality caused by four major chronic diseases in the death cause monitoring areas of Guangxi, 2008—2017[J]. Appl Prev Med, 2018, 24(5): 343-348. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX201805004.htm [8] 曾新颖, 李镒冲, 刘世炜, 等. 1990-2015年中国四类慢性病早死概率与健康中国2030下降目标分析[J]. 中华预防医学杂志, 2017, 51(3): 209-214. DOI: 10.3760/cma.j.issn.0253-9624.2017.03.004.Zeng XY, Li YC, Liu SW, et al. Premature death probability of four types of chronic diseases in China and the 2030 reduction target analysis of health China from 1990 to 2015[J]. Chin J Prev Med, 2017, 51(3): 209-214. DOI: 10.3760/cma.j.issn.0253-9624.2017.03.004. [9] 邱琳, 刘晨越, 飒日娜, 等. 2015—2018年陕西省居民心血管病死亡现状及寿命损失分析[J]. 现代预防医学, 2019, 46(19): 3535-3539. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201919021.htmQiu L, Liu CY, Sa RN, et al. Analysis on cardiovascular disease death and potential years of life lost in Shaanxi, 2015-2018[J]. Mod Prev Med, 2019, 46(19): 3535-3539. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201919021.htm [10] 刘杰, 颜玮, 刘明, 等. 江西省2014—2018年死因监测地区主要慢性病早死概率分析[J]. 中国卫生统计, 2020, 37(2): 253-255. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202002025.htmLiu J, Yan W, Liu M, et al. Probability analysis of premature death from major chronic diseases in cause of death monitoring areas in Jiangxi Province, 2014-2018[J]. Chin J Heal Stat, 2020, 37(2): 253-255. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202002025.htm [11] 王海明, 王春丽, 冯伟. 奉化区主要慢性非传染性疾病早死概率分析[J]. 预防医学, 2018, 30(2): 134-138. DOI: 10.19485/j.cnki.issn2096-5087.2018.02.007.Wang HM, Wang CL, Feng W. Premature mortality caused by four main non-communicable diseases in Fenghua District[J]. Prev Med, 2018, 30(2): 134-138. DOI: 10.19485/j.cnki.issn2096-5087.2018.02.007. [12] 董航, 李燕, 林国桢, 等. 2010—2017年广州市重大慢性非传染性疾病早死概率变化趋势分析[J]. 中国慢性病预防与控制, 2019, 27(6): 472-474. DOI: 10.16386/j.cjpccd.issn.1004-6194.2019.06.019.Dong H, Li Y, Lin GZ, et al. Analysis on the changing trend of the probability of early death from major chronic non-communicable diseases in Guangzhou from 2010 to 2017[J]. Chin J Prev Control Chronic Dis, 2019, 27(6): 472-474. DOI: 10.16386/j.cjpccd.issn.1004-6194.2019.06.019. [13] 刘峰. 陕西省慢性病及其危险因素监测报告[M]. 西安: 陕西科学技术出版社, 2019.Liu F. Monitoring report of chronic diseases and their risk factors in Shaanxi Province[M]. xi'an: Shaanxi Science and Technology Press, 2019. [14] 贺琴, 邢秀雅, 陈叶纪, 等. 2017年安徽省各市四大类慢性病早死概率测算[J]. 安徽预防医学杂志, 2019, 25(1): 10-13, 28. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF201901003.htmHe Q, Xing XY, Chen YJ, et al. Estimation of premature death probability of four kinds of chronic diseases at municipal level in Anhui Province in 2017[J]. Anhui J Prev Med, 2019, 25(1): 10-13, 28. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF201901003.htm [15] 丁贤彬, 唐文革, 焦艳, 等. 2010—2016年重庆市4种主要慢性病早死率及其变化趋势[J]. 中国慢性病预防与控制, 2017, 25(9): 641-645. DOI: 10.16386/j.cjpccd.issn.1004-6194.2017.09.001.Ding XB, Tang WG, Jiao Y, et al. The premature death rate and trend change of four major non-communicable diseases in Chongqing City from 2010 to 2016[J]. Chin J Prev Control Chronic Dis, 2017, 25(9): 641-645. DOI: 10.16386/j.cjpccd.issn.1004-6194.2017.09.001. -
