金昌队列人群随访十年主要慢性病死亡率与早死概率变化趋势

李思宇; 张德生; 胡雨佳; 王若楠; 陈亚荣; 李靖; 李娜; 许璐璐; 白朝; 张瑞; 白亚娜

doi:10.16462/j.cnki.zhjbkz.2022.05.005

金昌队列人群随访十年主要慢性病死亡率与早死概率变化趋势

doi: 10.16462/j.cnki.zhjbkz.2022.05.005

李思宇¹,
张德生²,
胡雨佳¹,
王若楠¹,
陈亚荣¹,
李靖¹,
李娜^{1, 3},
许璐璐¹,
白朝¹,
张瑞¹,
白亚娜^1, ,

1.
730000 兰州，兰州大学公共卫生学院流行病与卫生统计学研究所
2.
737100 金昌，金川集团职工医院医学影像科
3.
737100 金昌，金川集团职工医院体检中心

基金项目:

金川集团公司职工代谢性疾病全程管理体系建设 Jinkezong2020-02

详细信息

通讯作者:
白亚娜，E-mail: baiyana@lzu.edu.cn

中图分类号: R181;R195.4
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-06
- 修回日期: 2022-01-18
- 网络出版日期: 2022-05-11
- 刊出日期: 2022-05-10

Mortality and premature mortality in trends of variance in major chronic diseases in Jinchang Cohort during ten-year follow-up

1.
Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
2.
Medical Imaging Department, Workers' Hospital of Jinchuan Group, Jinchang 737100, China
3.
Physical Examination Center, Workers' Hospital of Jinchuan Group, Jinchang 737100, China

Funds:

Construction of the whole-process management system for metabolic diseases among staffs in Jinchuan Group Co Ltd Jinkezong2020-02

More Information

Corresponding author: BAI Ya-na, E-mail: baiyana@lzu.edu.cn

摘要

摘要: 目的分析金昌队列人群2011-2020年四种主要慢性病的死亡率、早死概率及变化趋势，锁定影响人群健康的核心病种，为人群慢性病防治提供基础数据。方法以金昌队列为平台，纳入基线全部人群48 001人，连续10年追踪随访其结局，应用简略寿命表法与joinpoint回归法计算死因构成比、粗死亡率、标化死亡率、早死概率及年度变化百分比(annual percent change, APC)等指标。结果 2011-2020年金昌队列人群4类主要慢性病平均死亡构成比为80.26%，4类主要慢性病粗死亡率呈上升趋势(APC=6.48%)，心脑血管疾病粗死亡率呈上升趋势(APC=10.02%)，其他三类疾病粗死亡率与标化死亡率均无变化趋势。除女性心脑血管疾病早死概率呈上升趋势外(APC=12.92%)，其他主要慢性病早死概率均无变化趋势。男性主要慢性病死亡率及早死概率高于女性。主要慢性病不同病种平均死亡率前3位为肺癌、脑卒中、冠心病。结论 4类主要慢性病是导致金昌队列人群死亡的主要疾病，肺癌、脑卒中为核心病种。男性为慢性病防治的重点人群，同时还应重点关注女性心脑血管疾病的防治，降低慢性病早死概率。
- 慢性病 /
- 早死概率 /
- 变化趋势 /
- 金昌队列
Abstract: Objective To identify the core diseases which affect population health, and to provide basic data for public prevention and treatment of chronic diseases through analyzing mortality rate, probability of premature mortality, and trends in chronic diseases from 2011 to 2020. Methods A total of 48 001 participants from the baseline in the Jinchang cohort were included in this study. Follow-up lasted for ten years to gain the outcome. Leading indicators for chronic diseases like proportionate mortality rate, crude mortality rate, age-standardized mortality rate, probability of premature death, and annual percent change (APC) were calculated using the abbreviated life table method and joinpoint regression model. Results The average proportionate mortality rate of major chronic diseases in the Jinchang cohort was 80.26%. The crude mortality rate of the four major chronic diseases showed an upward trend (APC=6.48%) during the observation period. The crude mortality rate of cardiovascular and cerebrovascular diseases was also on the rise (APC=10.02%). Except for women with cardiovascular and cerebrovascular diseases whose probability of premature mortality increased (APC=12.92%), probability of premature mortality in other major chronic diseases remained unchanged. The mortality rate and probability of premature mortality of major chronic diseases in men was higher than that in women. The top three average mortality rates of different major chronic diseases were lung cancer, stroke, and coronary heart disease. Conclusions The four major chronic diseases were the main causes of death in the Jinchang cohort, with lung cancer and stroke as the core diseases. Public prevention and treatment of chronic diseases need to focus more on males. Additionally, females are at a higher risk of cardiovascular and cerebrovascular diseases, which requires early prevention to reduce premature mortality from chronic diseases.
- Chronic diseases /
- Probability of premature death /
- Trend /
- Jinchang cohort

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图 1 2011-2020年金昌队列人群主要慢性病粗死亡率(/10万)

注：A：心脑血管疾病；B：恶性肿瘤；C：慢性呼吸系统疾病；D：糖尿病。

Figure 1. Crude mortality rate of major chronic diseases in the Jinchang cohort from 2011 to 2020 (/100 000)

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表 1 2011-2020年金昌队列人群主要慢性病死亡率(/10万)、构成比(%)及变化趋势

Table 1. The major chronic disease mortality rate (/100 000), proportionate mortality rate (%) and change trend of the Jinchang cohort population from 2011 to 2020

年份	男性						女性						合计
年份	N	X	n	PMR (%)	Mor (/10万)	ASMR (/10万)	N	X	n	PMR (%)	Mor (/10万)	ASMR (/10万)	N	X	n	PMR (%)	Mor (/10万)	ASMR (/10万)
2011	29 186	200	168	84.00	575.62	360.12	16 533	27	19	70.37	114.92	71.53	45 719	227	187	82.38	409.02	294.64
2012	29 248	231	195	84.42	666.71	399.93	17 699	26	20	76.92	113.00	138.84	46 947	257	215	83.66	457.96	329.96
2013	29 316	273	215	78.75	733.39	387.67	18 290	42	31	73.81	169.49	120.52	47 606	315	246	78.10	516.74	306.66
2014	29 516	256	202	78.91	684.37	378.19	18 314	51	42	82.35	229.33	289.16	47 830	307	244	79.48	510.14	348.28
2015	30 227	348	273	78.45	903.17	432.24	18 410	64	51	79.69	277.02	268.72	48 637	412	324	78.64	666.16	389.14
2016	30 417	354	290	81.92	953.41	426.31	18 507	78	61	78.21	329.61	173.51	48 924	432	351	81.25	717.44	356.80
2017	30 633	344	269	78.20	878.14	387.81	18 635	65	49	75.38	262.95	145.13	49 268	409	318	77.75	645.45	312.59
2018	31 114	381	301	79.00	967.41	414.33	19 368	82	65	79.27	335.61	245.08	50 482	463	366	79.05	725.01	345.85
2019	31 609	372	314	84.41	993.39	420.24	19 908	78	60	76.92	301.39	241.75	51 517	450	374	83.11	725.97	341.44
2020	32 670	392	318	81.12	973.37	417.36	20 117	90	70	77.78	347.96	157.16	52 787	482	388	80.50	735.03	341.57
合计	303 936	3 151	2 545	80.77	837.35	403.28	185 781	603	468	77.61	251.91	176.60	489 717	3 754	3 013	80.26	615.25	337.31
APC(%)				-0.18	5.75	1.22				0.55	11.24	4.13				-0.14	6.48	0.98
t值				-0.48	5.77	2.27				1.16	4.52	0.87				-0.47	5.94	1.09
P值				0.644	< 0.001	0.053				0.279	0.002	0.410				0.654	< 0.001	0.307
注：N表示该人群本年平均人口数，X表示本年总死亡人数，n表示本年因4类主要慢性病死亡的人数。比例死亡比(proportionate mortality rate, PMR)，PMR=n/X。粗死亡率(crude mortality rate, Mor)，Mor=n/N。年龄调整死亡率(age-standardized mortality rate, ASMR)。

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表 2 2011-2020年金昌队列人群主要慢性病不同病种平均死亡率(/10万)

Table 2. The average mortality rate of different types of chronic diseases in the Jinchang cohort from 2011 to 2020 (/100 000)

疾病种类	男性			女性			合计
疾病种类	n	Mor(/10万)	ASMR(/10万)	n	Mor(/10万)	ASMR(/10万)	N	Mor(/10万)	ASMR(/10万)
肺癌	381	125.36	59.45	54	29.07	16.01	435	88.83	46.47
脑卒中	355	116.80	56.04	57	30.68	38.74	412	84.13	49.67
冠心病	348	114.50	55.43	61	32.83	23.86	409	83.52	47.39
脑出血	167	54.95	25.86	34	18.30	12.95	201	41.04	21.47
胃癌	159	52.31	23.17	24	12.92	6.98	183	37.37	18.09
肝癌	127	41.79	21.74	22	11.84	6.72	149	30.43	16.25
糖尿病	109	35.86	17.74	24	12.92	6.41	133	27.16	15.04
慢性阻塞性肺病	87	28.62	13.21	15	8.07	4.86	102	20.83	11.41
食管癌	80	26.32	12.86	10	5.38	5.66	90	18.38	9.60
矽肺	84	27.64	12.12	2	1.08	0.97	86	17.56	9.08

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表 3 2011-2020年金昌队列人群主要慢性病早死概率(%)及变化趋势

Table 3. Probability of premature death(%) and change trend from chronic diseases in the Jinchang cohort from 2011 to 2020

疾病类别	早死概率(%)										APC (%)	t值	P值
疾病类别	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	APC (%)	t值	P值
男性
恶性肿瘤	8.25	9.05	11.28	6.77	8.44	8.99	5.84	8.89	6.30	7.37	-3.07	-1.53	0.164
心脑血管疾病	3.39	6.43	4.63	6.65	4.65	7.14	7.03	5.83	5.19	5.98	2.18	0.88	0.406
慢性呼吸系统疾病	1.33	0.79	1.14	0.00	1.74	1.54	0.94	0.62	1.62	0.52	-1.30	-0.29	0.779
糖尿病	0.45	0.47	1.60	0.51	0.78	0.00	0.29	1.06	0.71	0.52	-2.58	-0.42	0.684
小计^a	12.94	15.80	17.69	13.41	14.74	16.79	13.52	15.64	13.23	13.81	-0.83	-0.64	0.538
女性
恶性肿瘤	3.78	2.31	3.73	5.15	5.00	5.23	3.22	3.42	2.35	3.08	-2.41	-0.69	0.509
心脑血管疾病	0.99	0.61	1.37	2.01	1.97	3.39	2.31	3.35	1.24	3.54	12.92	2.63	0.030
慢性呼吸系统疾病	0.00	0.00	0.00	0.00	0.31	0.68	0.29	0.28	0.00	0.00	-14.75	-1.16	0.281
糖尿病	0.00	0.00	0.61	0.56	0.91	0.68	0.29	0.28	0.29	0.48	-9.58	-1.95	0.088
小计^a	4.74	2.90	5.63	7.58	8.00	9.70	4.10	7.20	4.02	6.96	2.55	0.59	0.569
合计
恶性肿瘤	6.60	6.54	8.22	6.11	7.09	7.52	4.74	6.70	4.66	5.53	-3.13	-1.75	0.119
心脑血管疾病	2.51	4.16	3.28	4.80	3.64	5.60	5.05	4.84	3.51	4.97	3.97	1.60	0.148
慢性呼吸系统疾病	0.83	0.45	0.67	0.00	1.17	1.18	0.68	0.50	0.91	0.29	-1.21	-0.25	0.812
糖尿病	0.28	0.17	1.24	0.55	0.83	0.24	0.28	0.72	0.52	0.49	-3.62	-0.52	0.616
小计	9.95	10.99	12.92	11.11	12.15	13.94	10.42	12.30	9.32	10.93	-0.32	-0.21	0.837
注：^a不同性别主要慢性病的早死概率。

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