2030年我国常见危险因素所致心脑血管疾病死亡和早死概率预测研究  

Prediction on the cardio-cerebrovascular death and probability of premature death caused by common risk factors in China in 2030

作　　者：饶蓁蓁 傅晏红 李若曈 徐婷玲 刘江美[2] 董文兰[2] 于石成[3] 胡国清[1,4] 周脉耕 Rao Zhenzhen;Fu Yanhong;Li Ruotong;Xu Tingling;Liu Jiangmei;Dong Wenlan;Yu Shicheng;Hu Guoqing;Zhou Maigeng(Department of Epidemiology and Health Statistics,Xiangya School of Public Health,Central South University,Changsha 410078,China;National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Office of Epidemiology Research,Chinese Center for Disease Control and Prevention,Beijing 102206,China;National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Central South University,Changsha 410078,China)

机构地区：[1]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410078 [2]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [3]中国疾病预防控制中心流行病学办公室,北京102206 [4]国家老年疾病临床医学研究中心,长沙410078

出　　处：《中华预防医学杂志》2022年第5期567-573,共7页Chinese Journal of Preventive Medicine

基　　金：国家重点研发计划(2018YFC1315304);湖南省自然科学基金(2020JJ4764);国家老年疾病临床医学研究中心临床研究基金(2020LNJJ14)。

摘　　要：目的采用预测模型评估实现我国常见危险因素对2030年我国心脑血管疾病死亡及早死概率的影响。方法利用2015年全球疾病负担估算的中国数据,计算各个危险因素的人群归因分值,采用比例变化模型估计2030年我国心脑血管疾病的不可归因死亡例数,并预测2030年该疾病的死亡例数、死亡率、标化死亡率和早死概率。结果根据危险因素在1990—2015年的自然变化趋势,2030年我国心脑血管疾病的死亡例数(612.44万例)和死亡率(428.53/10万)较2015年将分别增长59.92%和52.87%;2030年我国男性和女性心脑血管疾病的早死概率均呈持续下降的趋势,男性由11.43%降至11.28%,女性由5.79%降至4.43%。如果到2030年所纳入危险因素全部达标,可避免228.92万例心脑血管疾病患者死亡。在单个危险因素控制达标的情况下,血压、总胆固醇和细颗粒物暴露是对心脑血管疾病死亡数影响最大的3个因素,可分别减少死亡133.28、60.91和30.68万例。其中,血压控制对缺血性心脏病和出血性脑卒中死亡的贡献最大,分别可减少67.73和39.11万例的死亡。结论危险因素的控制对降低心脑血管疾病死亡的意义较大,如果2030年所有危险因素的控制目标均实现,可降低心脑血管的疾病负担。Objective Predictive models were used to evaluate the impact of common risk factors on the number of cardio-cerebrovascular deaths and the probability of premature death.Methods Using the data for China estimated by the Global Burden of Disease study 2015(GBD 2015),we calculated the population attribution fraction(PAF)of risk factors.The proportional change model was used to estimate the number of unattributable deaths by 2030,and to predict the number of deaths,mortality,standardized mortality and probability of premature death by 2030.Results According to the natural change trend of risk factors from 1990 to 2015,the number of deaths and mortality would reach 6.12 million and 428.53/100000 by 2030,with an increase of 59.92%and 52.87%.By 2030,the probability of premature death from cardio-cerebrovascular diseases among Chinese aged 30-70 years old would continue to decline,from 11.43%to 11.28%for men,and from 5.79%to 4.43%for women.If the goals of all included risk factors were reached by 2030,2289200 cardio-cerebrovascular deaths would be avoided.If only the exposure to a single risk factor was achieved by 2030,blood pressure,total cholesterol,and fine particulate matter exposure were the three most important factors affecting cardio-cerebrovascular deaths,which would reduce 1332800,609100 and 306800 deaths,respectively.Among the involved risk factors,the control of blood pressure would mostly decrease the number of deaths due to ischemic heart disease and hemorrhagic stroke,about 677300 and 391100 deaths,accordingly.Conclusion The control of risk factors is of great significance in reducing deaths and probability of premature death due to cardio-cerebrovascular diseases.If the control targets of all risk factors could be achieved by 2030,the burden of cardio-cerebrovascular diseases would be reduced greatly.

关 键 词：心血管疾病 卒中 死亡率 危险因素 早死概率 

分 类 号：R54[医药卫生—心血管疾病]