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湖南省1990-2017年脑卒中疾病负担

刘源 徐巧华 殷蕾 金东辉

刘源, 徐巧华, 殷蕾, 金东辉. 湖南省1990-2017年脑卒中疾病负担[J]. 中华疾病控制杂志, 2021, 25(1): 101-107. doi: 10.16462/j.cnki.zhjbkz.2021.01.019
引用本文: 刘源, 徐巧华, 殷蕾, 金东辉. 湖南省1990-2017年脑卒中疾病负担[J]. 中华疾病控制杂志, 2021, 25(1): 101-107. doi: 10.16462/j.cnki.zhjbkz.2021.01.019
LIU Yuan, XU Qiao-hua, YIN Lei, JIN Dong-hui. Disease burden of stroke from 1990 to 2017 in Hunan Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(1): 101-107. doi: 10.16462/j.cnki.zhjbkz.2021.01.019
Citation: LIU Yuan, XU Qiao-hua, YIN Lei, JIN Dong-hui. Disease burden of stroke from 1990 to 2017 in Hunan Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(1): 101-107. doi: 10.16462/j.cnki.zhjbkz.2021.01.019

湖南省1990-2017年脑卒中疾病负担

doi: 10.16462/j.cnki.zhjbkz.2021.01.019
基金项目: 

湖南省卫生健康委2020年度立项课题 20201255

详细信息
    通讯作者:

    金东辉,E-mail:942019814@qq.com

  • 中图分类号: R181

Disease burden of stroke from 1990 to 2017 in Hunan Province

Funds: 

Hunan Health Committee in 2020 20201255

More Information
  • 摘要:   目的  描述1990-2017年湖南省脑卒中疾病负担及变化趋势,为其防控政策的制定提供依据。  方法  描述2017年全球疾病负担研究(global burden of diseases study, GBD)结果中包括湖南省脑卒中死亡数、过早死亡损失寿命年(years of life lost, YLLs)、伤残损失寿命年(years lived with disability, YLDs)、伤残调整寿命年(disability-adjusted life years, DALYs)及各指标的年龄标化率,并计算各指标1990-2017年变化幅度。  结果  1990-2017年,湖南省脑卒中死亡数从7.69万上升至11.43万人年,升幅85.84%,男性、女性分别上升122.56%、2.12%;年龄标化死亡率从218.55/10万降至136.41/10万,降幅37.58%,男性、女性分别下降4.16%、58.18%。YLLs从163.74万人年升至203.57万人年,升幅84.79%,男性上升94.94%,女性下降22.62%;年龄标化YLL率下降从3 742.85/10万降至2 183.06/10万,降幅41.67%,女性下降64.45%,高于男性的6.62%。YLDs从11.35万人年上升至30.83万人年,升幅171.63%,男性、女性分别上升197.58%、151.72%;年龄标化YLD率升幅41.74%(1990年:235.13/10万,2017年:333.28/10万),男性、女性分别上升58.89%、28.22%。脑卒中DALYs从175.09万人年升至234.41万人年,升幅33.88%;年龄标化DALY率从3 977.98/10万降至2 516.34/10万,降幅36.74%。其中脑出血DALYs占比最高,缺血性卒中DALYs升幅最高,达142.64%。  结论  1990-2017年,湖南省脑卒中疾病负担整体呈增长趋势,有明显性别差异,脑出血疾病负担最重,缺血性卒中疾病负担上升最明显。
  • 图  1  湖南省1990-2017年脑卒中的年龄标化死亡率时间分布

    Figure  1.  Age-standardized mortality rates of stroke in Huan Province from 1990 to 2017

    表  1  两组患者一般资料比较a

    Table  1.   Comparison of basic features of the two groupa

    年份 性别 脑出血 缺血性卒中 蛛网膜下腔出血 脑卒中合计
    死亡数(万人) 标化死亡率(/10万) 死亡数(万人) 标化死亡率(/10万) 死亡数(万人) 标化死亡率(/10万) 死亡数(万人) 标化死亡率(/10万)
    1990 1.54(1.18~2.34) 86.14(66.49~128.57) 0.56(0.42~0.83) 36.67(27.98~53.42) 0.87(0.23~1.26) 46.80(11.68~68.28) 2.97(2.65~3.45) 169.60(152.08~195.96)
    2.15(1.76~3.69) 121.07(99.40~206.59) 0.90(0.71~1.55) 57.13(45.41~97.88) 1.67(0.58~2.10) 88.77(29.74~111.33) 4.72(4.10~5.98) 266.97(233.58~342.19)
    合计 3.70(3.05~5.93) 103.71(86.05~165.32) 1.46(0.75~1.56) 46.87(38.04~73.98) 2.54(0.87~3.18) 67.96(22.38~84.97) 7.69(6.97~9.35) 218.55(198.89~267.87)
    1995 1.68(1.28~2.58) 78.11(60.13~118.94) 0.63(0.47~0.98) 33.74(25.53~50.88) 1.07(0.26~1.53) 48.04(11.08~69.19) 3.38(3.07~3.92) 159.89(145.64~184.44)
    1.91(1.60~3.34) 93.76(78.88~164.73) 0.78(0.63~1.39) 43.06(35.37~76.75) 1.55(0.51~1.89) 72.54(23.50~88.23) 4.23(3.78~5.43) 209.36(186.59~271.90)
    合计 3.60(2.98~5.86) 85.64(71.29~139.05) 1.41(1.15~2.35) 38.14(31.27~62.65) 2.61(0.86~3.25) 59.96(19.13~74.50) 7.62(7.01~9.24) 183.74(168.98~225.04)
    2000 2.31(1.82~3.26) 90.35(71.87~126.45) 0.90(0.70~1.29) 39.87(31.54~56.20) 1.15(0.28~1.68) 43.68(10.41~63.63) 4.36(3.89~4.90) 173.90(156.91~194.88)
    1.89(1.60~2.88) 77.97(66.34~119.03) 0.81(1.26~0.68) 37.22(31.29~57.43) 1.05(0.37~1.27) 41.85(14.49~50.71) 3.76(3.32~4.62) 157.05(138.85~193.81)
    合计 4.21(3.55~6.03) 84.22(71.48~120.42) 1.71(1.43~2.49) 38.47(32.53~55.49) 2.20(0.73~2.84) 42.71(13.91~54.84) 8.12(7.46~9.40) 165.40(152.39~191.98)
    2005 3.17(2.75~3.85) 106.4(92.96~127.68) 1.37(1.18~1.66) 51.23(44.64~61.63) 0.79(0.28~1.08) 25.76(8.95~35.20) 5.33(4.89~5.90) 183.40(169.27~201.98)
    2.10(1.86~2.63) 69.92(62.38~87.64) 0.99(0.88~1.24) 35.99(32.03~44.81) 0.60(0.28~0.71) 19.34(8.77~22.66) 3.69(3.34~4.20) 125.25(113.91~142.39)
    合计 5.27(4.75~6.38) 87.8(79.51~105.52) 2.36(2.13~2.85) 43.28(39.18~52.06) 1.40(0.63~1.74) 22.48(10.17~27.78) 9.03(8.42~9.97) 153.56(143.47~169.54)
    2010 3.33(2.93~3.91) 97.18(86.12~112.99) 1.76(1.53~2.08) 56.88(50.11~66.92) 0.63(0.27~0.85) 17.86(7.63~23.89) 5.71(5.15~6.41) 171.91(155.55~192.23)
    2.24(1.97~2.64) 62.35(55.39~73.69) 1.34(1.18~1.58) 39.36(35.01~45.90) 0.50(0.28~0.58) 13.69(7.75~15.86) 4.08(3.67~4.58) 115.39(103.90~129.34)
    合计 5.56(5.06~6.50) 79.17(72.38~92.20) 3.10(2.82~3.63) 47.57(43.53~55.35) 1.13(0.67~1.37) 15.73(9.37~18.91) 9.79(9.08~10.81) 142.48(132.43~157.50)
    2015 3.55(2.95~4.35) 88.69(74.38~107.97) 2.07(1.73~2.52) 56.50(47.55~67.98) 0.68(0.30~0.95) 16.66(23.02~7.54) 6.31(5.38~7.45) 161.85(139.28~190.43)
    2.54(2.10~3.07) 60.90(50.58~73.49) 1.64(1.35~2.00) 41.22(34.33~49.84) 0.59(0.34~0.72) 13.81(7.93~16.78) 4.77(3.98~5.63) 115.92(97.38~136.39)
    合计 6.09(5.29~7.23) 74.59(64.97~88.01) 3.71(3.23~4.40) 48.61(42.57~57.30) 1.27(0.79~1.59) 15.28(9.55~18.99) 11.08(9.73~12.66) 138.48(122.24~157.53)
    2017 3.69(2.96~4.62) 88.60(71.77~110.13) 2.18(1.78~2.68) 56.66(46.77~69.39) 0.74(0.32~1.07) 17.30(7.66~24.90) 6.61(5.39~8.14) 162.55(134.55~197.88)
    2.58(2.07~3.19) 58.96(47.48~72.71) 1.63(1.30~2.05) 38.95(47.42~48.95) 0.61(0.34~0.78) 13.73(7.71~17.38) 4.82(3.95~5.80) 111.64(91.75~134.17)
    合计 6.27(5.30~7.56) 73.44(62.36~88.15) 3.80(3.21~4.59) 47.42(40.43~56.72) 1.35(0.82~1.75) 15.54(9.41~19.85) 11.43(3.95~13.33) 136.41(117.26~158.14)
    变化 139.61 2.86 289.29 54.51 -14.94 -63.03 122.56 -4.16
    幅度(%) 20.00 -51.30 81.11 -31.82 -63.47 -84.53 2.12 -68.43
    合计 69.46 -29.19 160.27 1.81 -47.03 -77.13 48.63 -37.58
    注:a括号内表示95% UIs
    下载: 导出CSV

    表  2  湖南省1990-2017年卒中的YLLs、YLDs与其变化(/10万)a

    Table  2.   YLLs, YLDs and changes caused by stroke in Hunan Province from 1990 to 2017 (/100 000)a

    年份(年) 性别 YLLs(万人年) 年龄标化YLL率 YLDs(万人年) 年龄标化YLD率
    1990 65.39(58.21~76.43) 2935.99(2617.65~3417.26) 4.95(3.51~6.41) 201.19(143.47~259.19)
    98.35(86.20~121.66) 4552.58(3997.03~5667.79) 6.40(4.49~8.18) 270.29(191.13~345.34)
    合计 163.74(148.82~195.68) 3742.85(3404.47~4509.73) 11.35(8.11~14.47) 235.13(167.18~300.43)
    1995 73.36(66.15~85.59) 2809.96(2545.52~3253.93) 5.84(4.13~7.49) 209.34(149.32~268.73)
    88.01(78.51~109.02) 3588.45(3207.68~4496.81) 6.95(4.88~8.93) 264.84(188.13~338.89)
    合计 161.37(148.90~192.2) 3189.46(2941.56~3833.43) 12.79(9.04~16.36) 236.15(168.80~301.83)
    2000 91.05(80.87~103.08) 3020.05(2696.11~3407.41) 7.07(5.06~9.12) 224.55(160.54~287.46)
    73.91(65.08~88.35) 2598.35(2293.43~3129.91) 7.74(5.51~9.89) 259.92(186.10~331.96)
    合计 164.96(151.10~189.03) 2813.79(2584.03~3234.67) 14.82(10.57~18.94) 241.72(173.94~308.60)
    2005 106.91(97.54~119.12) 3110.29(2851.75~3450.53) 8.22(5.89~10.51) 233.55(166.68~298.70)
    66.47(60.18~75.34) 1980.65(1797.18~2246.08) 8.73(6.21~11.15) 256.90(182.30~328.01)
    合计 173.38(161.06~190.94) 2547.58(2371.57~2806.83) 16.95(12.13~21.52) 245.21(175.58~310.79)
    2010 109.30(97.69~123.23) 2817.05(2529.15~3170.49) 9.77(7.00~12.45) 247.35(177.85~315.95)
    65.71(58.89~74.00) 1693.99(1519.60~1908.07) 10.46(7.49~13.28) 270.29(193.72~344.66)
    合计 175.01(161.59~194.85) 2252.88(2084.48~2505.46) 20.22(14.49~25.64) 258.95(185.93~327.69)
    2015 124.39(104.90~148.56) 2785.07(2362.77~3315.24) 12.88(9.19~16.54) 292.11(208.54~376.08)
    76.37(63.56~90.72) 1703.35(1418.65~2015.69) 13.95(9.94~17.86) 317.08(226.56~405.27)
    合计 200.76(174.80~230.89) 2245.53(1960.84~2579.16) 26.83(19.17~34.31) 304.73(218.38~391.19)
    2017 127.47(103.05~158.59) 2753.51(2235.62~3393.69) 14.73(10.52~19.08) 319.67(228.21~411.87)
    76.10(61.64~93.01) 1618.25(1315.04~1972.89) 16.11(11.43~20.76) 346.57(245.84~446.02)
    合计 203.57(172.64~238.38) 2183.06(1862.24~2550.31) 30.83(22.00~39.60) 333.28(228.52~427.64)
    变化 94.94 -6.22 197.58 58.89
    幅度(%) -22.62 -64.45 151.72 28.22
    合计 24.33 -41.67 171.63 41.74
    注:a括号内表示95%UIs
    下载: 导出CSV

    表  3  湖南省1990-2017年不同种卒中的DALYs与变化情况a

    Table  3.   DALYs caused by stroke and changes in Hunan Province from 1990 to 2017a

    时间(年) 负担指标 脑出血 缺血性卒中 蛛网膜下腔出血 脑卒中合计
    1990 DALYs(万人年) 82.71(68.91~128.42) 34.52(28.77~50.34) 57.87(23.05~71.46) 175.09(160.01~206.75)
    年龄标化DALY率(/10万) 1 864.03(1 552.75~2 917.66) 841.39(699.56~1 238.16) 1 272.55(479.15~1 576.35) 3 977.98(3 642.06~4 748.04)
    1995 DALYs(万人年) 80.86(67.36~127.35) 34.34(28.37~51.28) 58.96(22.86~72.5) 174.16(161.03~204.99)
    年龄标化DALY率(/10万) 1 573.03(1 313.15~2 496.17) 718.25(596.51~1076.09) 1 134.32(417.06~1 397.05) 3 425.61(3 165.37~4 051.61)
    2000 DALYs(万人年) 91.49(77.66~128.62) 39.80(33.48~53.95) 48.49(19.17~61.59) 179.78(165.57~203.54)
    年龄标化DALY率(/10万) 1 532.53(1 301.80~2 161.65) 714.46(603.89~967.39) 808.51(309.91~1 028.43) 3 055.51(2 819.92~3 476.85)
    2005 DALYs(万人年) 108.73(97.99~130.87) 51.12(45.31~59.88) 30.49(15.82~37.34) 190.33(177.40~208.78)
    年龄标化DALY率(/10万) 1 572.31(1 420.91~1 889.94) 784.69(698.59~918.37) 435.79(222.57~533.39) 2 792.79(2 609.06~3 061.44)
    2010 DALYs(万人年) 108.43(98.60~126.97) 62.62(56.21~71.71) 24.17(15.60~28.86) 195.23(180.18~215.77)
    年龄标化DALY率(/10万) 1 374.40(1 255.53~1 607.00) 832.58(748.28~951.51) 304.84(196.63~361.93) 2 511.83(2 323.42~2 776.29)
    2015 DALYs(万人年) 120.74(104.23~142.70) 79.53(69.13~92.15) 27.32(17.68~34.31) 227.59(199.55~257.58)
    年龄标化DALY率(/10万) 1 333.45(1154.55~1582.06) 913.57(796.23~1 057.96) 303.23(197.21~378.85) 2 550.26(2 243.46~2 883.71)
    2017 DALYs(万人年) 122.12(102.82~147.20) 83.76(71.68~98.03) 28.53(17.82~36.95) 234.41(76.83~270.24)
    年龄标化DALY率(/10万) 1 294.65(1 096.17~1 561.53) 917.64(789.18~1 070.71) 304.05(191.87~391.89) 2 516.34(1 635.78~2 896.3)
    变化 DALYs(万人年) 47.65 142.64 -50.70 33.88
    幅度(%) 年龄标化DALY率(/10万) -30.55 9.06 -76.11 -36.74
    注:a括号内表示95%UIs
    下载: 导出CSV
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  • 收稿日期:  2020-03-19
  • 修回日期:  2020-09-13
  • 刊出日期:  2021-01-10

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