Analysis of disease burden in Guangzhou, 2010-2020
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摘要:
目的 评价2010-2020年广州市人群疾病负担的变化趋势,分析其性别和年龄差异。 方法 使用2010-2020年广州市死因监测数据和人口学数据测算伤残调整寿命年(disability-adjusted life years, DALY),Joinpoint回归分析模型分析DALY的变化趋势。 结果 2020年广州市男女粗死亡率分别为640.87/10万人和464.49/10万人,主要死因为心血管疾病、肿瘤和慢性呼吸道疾病。2010-2020年,男性心血管疾病上升为疾病负担首位,肌肉骨骼疾病、皮肤和皮下疾病、意外伤害和营养不良的疾病负担顺位上升。女性心血管疾病保持疾病负担首位,肌肉骨骼疾病、营养不良、神经失调、意外伤害、皮肤和皮下疾病的疾病负担顺位上升。男性和女性的总DALY基本保持不变,但粗率和中标率呈下降趋势。不同年龄组的疾病负担顺位有所差异。 结论 2010-2020年广州市疾病负担以非传染性疾病为主,不同性别和年龄人群的疾病负担模式具有各自特征。应结合城市层面的主要健康问题,探明危险因素,针对重点人群疾病制定有效的预防控制策略。 Abstract:Objective To evaluate the trend of disease burden in Guangzhou from 2010 to 2020, and to analyze gender and age differences. Methods The disability-adjusted life years (DALY) was calculated using cause-of-death surveillance data and demographic data from 2010 to 2020 in Guangzhou, and the trend of DALY was analyzed using the Joinpoint regression model. Results In 2020, the crude death rates of males and females in Guangzhou were 640.87 and 464.49 per 100 000, respectively, mainly due to cardiovascular diseases, neoplasms, and chronic respiratory diseases. From 2010 to 2020, cardiovascular diseases rose to the top cause of the disease burden in males, while the orders of musculoskeletal disorders, skin and subcutaneous diseases, unintentional injuries, and nutritional deficiencies have risen. Cardiovascular diseases remained the first cause of the disease burden in females, while the orders of musculoskeletal disorders, nutritional deficiencies, neurological disorders, unintentional injuries, skin and subcutaneous diseases have risen. The total DALY of males and females was unchanged, but the crude rate and age-standardized rate decreased. The order of disease burden varied among different age groups. Conclusions From 2010 to 2020, the disease burden in Guangzhou is dominated by non-communicable diseases, and the disease burden patterns of different genders and age groups have their characteristics. Risk factors should be identified based on main health problems at the urban level, and effective prevention and control strategies should be formulated for the diseases of key populations. -
表 1 2020年广州市人群死亡情况
Table 1. Mortality in Guangzhou City in 2020
死因 男性 女性 死亡数[n(%)] 死亡率(/10万) 死亡数[n(%)] 死亡率(/10万) 粗率 中标率 粗率 中标率 HIV/AIDS和性传播疾病 58(0.18) 1.19 0.95 8(0.03) 0.16 0.22 呼吸道感染和肺结核 582(1.86) 11.90 7.94 357(1.55) 7.20 7.04 肠道感染 41(0.13) 0.84 0.64 29(0.13) 0.58 0.74 热带病和疟疾 11(0.04) 0.22 0.15 8(0.03) 0.16 0.18 产妇和新生儿疾病 64(0.20) 1.31 1.50 47(0.20) 0.95 2.33 营养不良 276(0.88) 5.64 3.59 498(2.16) 10.04 8.49 肿瘤 9 580(30.55) 195.81 132.13 5 727(24.87) 115.50 139.43 心血管疾病 11 720(37.38) 239.55 157.42 10 822(46.99) 218.25 209.27 慢性呼吸道疾病 4 071(12.98) 83.21 53.60 1 573(6.83) 31.72 28.82 消化道疾病 1 210(3.86) 24.73 16.76 811(3.52) 16.36 16.08 神经失调 259(0.83) 5.29 3.82 306(1.33) 6.17 6.98 精神障碍 14(0.04) 0.29 0.20 9(0.04) 0.18 0.14 物质滥用 58(0.18) 1.19 0.95 0(0.00) 0.00 0.00 糖尿病和肾脏病 1 220(3.89) 24.94 16.61 1 021(4.43) 20.59 22.27 皮肤和皮下疾病 41(0.13) 0.84 0.55 51(0.22) 1.03 0.98 肌肉骨骼疾病 55(0.18) 1.12 0.79 113(0.49) 2.28 2.81 交通伤害 382(1.22) 7.81 6.57 173(0.75) 3.49 5.38 自残和人际暴力 432(1.38) 8.83 7.94 254(1.10) 5.12 8.58 意外伤害 965(3.08) 19.72 14.36 893(3.88) 18.01 19.84 其他传染性疾病 49(0.16) 1.00 0.78 36(0.16) 0.73 1.14 其他非传染性疾病 267(0.85) 5.46 4.16 296(1.29) 5.97 8.36 合计 31 355(100.00) 640.87 431.41 23 032(100.00) 464.49 242.48 表 2 2010-2020年广州市人群按年龄分组的疾病负担情况
Table 2. Disease burden by age group in Guangzhou City, 2010-2020
年龄组(岁) 绝对数量/率 2010-2020年平均年度变化百分比(%) DALY(%) DALY率(人年/千) DALY(%) DALY率(人年/千) 粗率 中标率 粗率 中标率 男性 0~<10 31 108.10(3.01) 41.00 40.68 -4.0(-5.4~-2.5) -11.2(-12.8~-9.6) -11.3(-12.9~-9.7) 10~<25 30 224.42(2.93) 41.44 43.04 -7.2(-9.3~-5.0) -4.8(-6.9~-2.8) -4.6(-6.8~-2.5) 25~<50 190 141.40(18.42) 99.85 103.04 -3.2(-4.0~-2.3) -4.1(-4.8~-3.4) -4.0(-4.7~-3.4) 50~<75 541 585.80(52.46) 418.52 408.80 2.4(2.0~2.8) -1.5(-2.5~-0.5) -1.6(-1.9~-1.2) ≥75 259 123.70(25.10) 944.87 826.67 2.7(2.2~3.2) -0.1(-0.6~0.3) -0.7(-1.2~-0.3) 合计 1 032 432.00(100.00) 211.02 183.49 0.5(0.2~0.8) -1.3(-1.7~-0.9) -2.6(-2.9~-2.3) 女性 0~<10 19 669.36(2.37) 29.85 29.52 -4.0(-6.5~-1.5) -11.3(-13.7~-9.0) -11.5(-13.8~-9.1) 10~<25 36 033.67(4.34) 56.19 57.91 -4.5(-6.9~-2.1) -1.5(-3.7~0.8) -1.1(-3.4~1.1) 25~<50 186 594.70(22.50) 91.43 93.58 -0.8(-1.4~-0.2) -2.7(-3.4~-2.0) -2.6(-3.3~-1.9) 50~<75 327 892.70(39.54) 244.11 236.15 1.9(1.3~2.4) -2.0(-2.4~-1.5) -2.3(-2.8~-1.8) ≥75 259 123.70(31.25) 944.87 826.67 3.1(2.2~4.0) 0.1(-0.4~0.6) -0.7(-1.7~0.2) 合计 829 314.10(100.00) 167.25 134.44 0.9(0.6~1.2) -1.2(-1.9~-0.6) -2.5(-2.9~-2.1) 表 3 2020年广州市人群按年龄分组的疾病负担顺位(%)
Table 3. Orders of disease burden by age group of Guangzhou City in 2020 (%)
年龄组(岁) 1 2 3 4 5 男性 0~<10 产妇和新生儿疾(26.02) 意外伤害(16.06) 神经失调(7.21) 肠道感染(7.06) 肿瘤(6.56) 10~<25 营养不良(24.24) 自残和人际暴力(17.43) 神经失调(11.89) 交通伤害(10.03) 肿瘤(7.53) 25~<50 肌肉骨骼疾病(26.03) 肿瘤(14.71) 心血管疾病(11.17) 皮肤和皮下疾病(8.89) 神经失调(5.07) 50~<75 肿瘤(29.46) 心血管疾病(23.57) 肌肉骨骼疾病(8.77) 糖尿病和肾脏病(5.77) 慢性呼吸道疾病(5.37) ≥75 心血管疾病(37.81) 肿瘤(17.83) 慢性呼吸道疾病(17.74) 糖尿病和肾脏病(4.34) 意外伤害(4.12) 女性 0~<10 营养不良(22.12) 产妇和新生儿疾(19.59) 意外伤害(12.06) 肿瘤(7.92) 肠道感染(5.28) 10~<25 神经失调(29.65) 营养不良(17.66) 自残和人际暴力(8.13) 肌肉骨骼疾病(7.71) 慢性呼吸道疾病(6.16) 25~<50 肌肉骨骼疾病(28.60) 肿瘤(13.31) 营养不良(11.88) 神经失调(8.57) 心血管疾病(4.23) 50~<75 肌肉骨骼疾病(20.91) 肿瘤(20.40) 心血管疾病(13.83) 精神障碍(6.57) 产妇和新生儿疾病(6.31) ≥75 心血管疾病(44.40) 肿瘤(11.46) 慢性呼吸道疾病(7.48) 肌肉骨骼疾病(5.55) 意外伤害(5.54) -
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