中国分地区人口死因状况及去死因期望寿命分析

陶梦梦; 田纬; 李坤坤; 曹文君

doi:10.16462/j.cnki.zhjbkz.2024.03.002

中国分地区人口死因状况及去死因期望寿命分析

doi: 10.16462/j.cnki.zhjbkz.2024.03.002

陶梦梦¹,
田纬²,
李坤坤²,
曹文君^{1, 2, 3, ,}

1.
山西医科大学公共卫生学院统计学教研室，太原 030001
2.
山西医科大学公共卫生学院社会医学教研室，太原 030001
3.
长治医学院公共卫生与预防医学系，长治 046013

基金项目:

山西省卫生健康委科研课题 2023002

山西省教育科学“十四五”规划课题 GH-220226

详细信息

通讯作者:
曹文君，E-mail: wjcao16@czmc.edu.cn

中图分类号: R195
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- 被引次数: 0
出版历程
- 收稿日期: 2023-09-20
- 修回日期: 2024-01-05
- 网络出版日期: 2024-04-08
- 刊出日期: 2024-03-10

Analysis of mortality status and cause-eliminated life expectancy by region in China

TAO Mengmeng¹,
TIAN Wei²,
LI Kunkun²,
CAO Wenjun^{1, 2, 3
, ,}

1.
Department of Statistics, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
2.
Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
3.
Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046013, China

Funds:

Scientific Research Project of Shanxi Provincial Health Commission 2023002

The "14th Five-Year Plan" Research project of Shanxi Provincial Department of Education GH-220226

More Information

Corresponding author: CAO Wenjun, E-mail: wjcao16@czmc.edu.cn

摘要

摘要: 目的分析1990―2019年中国慢性肾病的发病时间趋势，评估年龄、时期和队列效应，并预测2020―2034年中国慢性肾病的发病情况，为慢性肾病相关防治政策和措施提供参考依据。方法利用2019全球疾病负担研究(Global Burden of Disease Study 2019, GBD 2019)数据，应用Joinpoint回归模型分析不同性别慢性肾病发病趋势变化并计算年度变化百分比(annual percentage change, APC)与平均年度变化百分比(average annual percentage change, AAPC)；借助年龄-时期-队列模型分析年龄、时期及队列因素对不同性别慢性肾病发病率的影响；采用贝叶斯年龄-时期-队列分析方法预测2020―2034年不同性别慢性肾病的发病率和发病人数。结果 1990―2019年中国全人群和男、女性慢性肾病标准化发病率总体均呈上升趋势(AAPC=0.30%、0.30%、0.29%, 均P < 0.001)，女性在1993―1996年(APC=-0.54%, P=0.073)无规律变化，女性较男性有更高的发病率, 但近年男性发病率增长速度远高于女性。中国慢性肾病发病率变化受年龄、时期、队列因素影响(均P < 0.001)，慢性肾病发病风险总体上随年龄增加而增加，在60岁之后明显上升；在1995年之后随时期持续上升；在2005年之前随出生队列上升，在2005年之后随出生队列下降。2020―2034年中国慢性肾病标化发病率和发病人数预计呈上升趋势，且男性增长幅度高于女性。结论 1990―2019年中国慢性肾病发病率和发病人数总体不断升高。建议加强对老年人以及高血压和糖尿病患者等高危人群的防护和婴幼儿的营养摄入和健康检查。
- 死亡率 /
- 死因顺位 /
- 期望寿命 /
- 趋势
Abstract: Objective To analyze the incidence time trend of chronic kidney disease (CKD) in China from 1990 to 2019, evaluate its age, period and cohort effect, and predict the incidence of chronic kidney disease in China from 2020 to 2034, so as to provide reference for relevant prevention and treatment policies and measures of CKD. Methods Based on the data of the Global Burden of Disease Study 2019(GBD 2019), the Joinpoint regression model was used to analyze the trend change of chronic kidney disease in different genders, and the annual percentage change (APC) and the average annual percentage change (AAPC) were calculated. With the help of age-period-cohort model, the influence of age, period and cohort factors on the incidence of CKD in different sexes was analyzed. Bayesian age-period-cohort analysis was used to predict the incidence and number of CKD in different gender from 2020 to 2034. Results From 1990 to 2019, the standardized incidence rate of CKD in the entire population, as well as among men and women in China, demonstrated an overall upward trajectory (AAPC=0.30%, 0.30%, 0.29%, all P < 0.001). Notably, there was an irregular variation observed in women during the years 1993-1996 (APC=-0.54%, P=0.073), with females exhibiting a higher incidence rate than males. However, the incidence rate in males has escalated at a significantly higher pace than that in females in recent years. The fluctuations in chronic kidney disease incidence in China were influenced by age, period, and cohort factors (all P < 0.001). The overall risk of CKD increased with age, experiencing a notable rise after the age of 60. Furthermore, the incidence continued to rise post-1995, associated with birth cohorts before 2005, and demonstrated a decline after 2005. Projections for the period from 2020 to 2034 anticipate an upward trend in the standardized incidence rate and the number of cases of chronic kidney disease in China, with a more pronounced increase among males compared to females. Conclusions From 1990 to 2019, the incidence rate and the number of cases of CKD in China demonstrated a continuous upward trend. It is advisable to bolster preventive measures for the elderly and high-risk populations, particularly individuals with hypertension and diabetes. Moreover, careful consideration should be given to the nutritional intake and health assessments of infants and young children.
- Mortality /
- Rank order of death causes /
- Life expectancy /
- Trend

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图 1 2010、2015、2020年东(A)、中(B)、西(C)部地区人口主要疾病死因寿命延长数

Figure 1. Cause-eliminated life expectancy extention in regions East(A), Central(B), West(C) in 2000, 2015 and 2020

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图 2 2010、2015、2020年东(A)、中(B)、西(C)部地区人口主要疾病死因寿命损失率

Figure 2. Potential years of life lost rate of major diseases in regions East(A), Central(B), West(C) in 2000, 2015 and 2020

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表 1 2010、2015、2020年分地区人口死亡率

Table 1. Mortality rate by region in 2010, 2015 and 2020

地区Region	粗死亡率/100 000^-1 Crude death rate/100 000^-1	年龄标化死亡率/100 000^-1 Age-standardized death rate/100 000^-1	Z值value	P值value
东部Eastern region			52.08	< 0.001
2020年year	680.25	628.57
2015年year	674.00	747.71
2010年year	573.93	910.68
中部Central region			55.55	< 0.001
2020年year	676.25	722.55
2015年year	629.66	819.23
2010年year	588.01	1 051.98
西部Western region			54.78	< 0.001
2020年year	674.22	789.82
2015年year	640.63	838.66
2010年year	561.70	1 056.37
注：Z值，各地区的粗死亡率进行Cochran-Armitage趋势检验的Z统计量。 Note: Z value, Z-statistic after Cochran-Armitage trend test for regional crude death rate.

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表 2 2010、2015、2020年分地区人口期望寿命表

Table 2. Life expectancy table by region in 2010, 1015 and 2020

年龄组/岁 Age group/years	东部Eastern region			中部Central region			西部Western region
年龄组/岁 Age group/years	2010年 year	2015年 year	2020年 year	2010年 year	2015年 year	2020年 year	2010年 year	2015年 year	2020年 year
0~ < 1	78.01	79.22	81.16	76.28	78.09	79.67	75.37	77.31	78.44
1~ < 5	77.30	78.48	80.29	75.61	77.37	78.82	75.08	76.73	77.64
5~ < 10	73.42	74.57	76.35	71.77	73.49	74.89	71.40	72.93	73.74
10~ < 15	68.48	69.62	71.40	66.85	68.55	69.94	66.54	68.03	68.83
15~ < 20	63.55	64.69	66.46	61.94	63.64	65.01	61.65	63.13	63.91
20~ < 25	58.65	59.77	61.55	57.03	58.72	60.10	56.79	58.26	59.01
25~ < 30	53.78	54.84	56.63	52.16	53.80	55.18	51.99	53.39	54.13
30~ < 35	48.91	49.96	51.70	47.30	48.96	50.28	47.22	48.60	49.27
35~ < 40	44.08	45.12	46.82	42.48	44.13	45.43	42.48	43.87	44.44
40~ < 45	39.29	40.29	41.98	37.70	39.32	40.60	37.77	39.11	39.67
45~ < 50	34.58	35.54	37.21	33.01	34.61	35.85	33.17	34.49	34.95
50~ < 55	29.97	30.87	32.50	28.44	29.96	31.19	28.69	29.91	30.37
55~ < 60	25.43	26.41	27.92	23.98	25.65	26.68	24.27	25.72	26.40
60~ < 65	21.04	22.00	23.47	19.71	21.28	22.37	20.00	21.35	22.14
65~ < 70	16.89	17.92	19.30	15.76	17.26	18.20	16.05	17.45	17.95
70~ < 75	12.95	14.31	15.36	12.07	13.75	14.36	12.28	13.82	14.11
75~ < 80	9.33	10.95	11.83	8.79	10.62	11.01	8.95	10.60	10.64
80~ < 85	6.10	7.96	8.71	5.79	7.84	8.16	5.86	7.81	7.87
≥85	3.14	5.55	6.12	3.08	5.77	6.04	3.03	5.63	5.92

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表 3 2010、2015、2020年分地区人口死因顺位分析

Table 3. Analysis of population cause of death rank by region in 2010, 2015 and 2020

疾病Disease	东部Eastern region
	2010年year		2015年year		2020年year
	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1
恶性肿瘤Cancer	1	148.24	1	181.08	1	180.12
脑血管病Cerebrovascular disease	2	129.50	2	147.00	2	148.11
心脏病Heart disease	3	90.19	3	123.31	3	137.61
呼吸系统疾病Respiratory disease	4	59.14	4	58.79	5	40.97
伤害Injury	5	46.88	5	45.44	4	44.92
感染病和寄生虫病Infectious and parasitic diseases	6	18.40	6	17.79	7	14.25
糖尿病Diabetes	7	12.04	7	15.33	6	18.26
消化系统疾病Digestive diseases	8	11.51	8	12.35	9	13.72
神经系统和精神障碍疾病Neurological and mental disorders	9	9.29	9	11.59	8	14.08
泌尿生殖系统疾病Genitourinary diseases	10	6.15	10	5.95	10	5.60

疾病Disease	中部Central region
	2010年year		2015年year		2020年year
	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1
恶性肿瘤Cancer	2	142.00	2	146.15	2	157.49
脑血管病Cerebrovascular disease	1	144.86	1	153.13	1	164.25
心脏病Heart disease	3	97.41	3	124.36	3	153.53
呼吸系统疾病Respiratory disease	4	63.62	4	54.47	4	42.90
伤害Injury	5	51.37	5	46.55	5	42.85
感染病和寄生虫病Infectious and parasitic diseases	6	15.88	6	16.24	7	13.68
糖尿病Diabetes	8	10.07	7	12.09	6	16.95
消化系统疾病Digestive diseases	7	10.74	8	10.84	8	11.43
神经系统和精神障碍疾病Neurological and mental disorders	10	5.87	10	6.13	9	9.00
泌尿生殖系统疾病Genitourinary diseases	9	7.53	9	7.03	10	7.48

疾病Disease	西部Western region
	2010年year		2015年year		2020年year
	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1	顺序 Rank	死亡率/100 000^-1 Mortality rate/100 000^-1
恶性肿瘤Cancer	2	114.70	1	137.96	2	139.82
脑血管病Cerebrovascular disease	1	117.96	2	133.40	1	150.98
心脏病Heart disease	4	61.79	4	90.12	3	113.58
呼吸系统疾病Respiratory disease	3	96.61	3	92.94	4	79.47
伤害Injury	5	57.19	5	54.91	5	50.34
感染病和寄生虫病Infectious and parasitic diseases	6	27.69	6	24.77	7	19.48
糖尿病Diabetes	8	7.89	8	12.69	8	17.39
消化系统疾病Digestive diseases	7	18.62	7	21.07	6	23.27
神经系统和精神障碍疾病Neurological and mental disorders	10	7.18	9	8.47	9	11.34
泌尿生殖系统疾病Genitourinary diseases	9	7.78	10	8.28	10	8.77
注：心脏病包括缺血性、风湿性心脏病；感染病和寄生虫病包括传染病、寄生虫病和呼吸系统感染性疾病。 Note: Heart disease includes ischemic and rheumatic heart disease; Infectious and parasitic diseases include infectious diseases, parasitic diseases and infectious diseases of the respiratory system.

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