2015~2019年中国居民脑卒中发病与死亡特征分析  

Trends of Stroke Incidence and Mortality From 2015 to 2019 in China

作　　者：陈晓荣[1] 颜流霞[1] 厚磊[1] 蔡小宁[1] 龙政 吴静[1] CHEN Xiaorong;YAN Liuxia;HOU Lei;CAI Xiaoning;LONG Zheng;WU Jing(National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Medical Affairs Office,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]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 [2]首都医科大学宣武医院医务处,北京100053

出　　处：《中国循环杂志》2024年第5期470-476,共7页Chinese Circulation Journal

基　　金：中央补助地方公共卫生专项慢性病综合干预“中国居民心脑血管事件报告试点项目(2014-2020)”。

摘　　要：目的:分析2015~2019年中国居民脑卒中发病、死亡特征及其变化情况。方法:利用2014年在全国31个省级行政区100个县(市、区)建立的中国心脑血管事件登记系统中2015~2019年脑卒中发病和死亡数据,以监测地区常住人口为分母,计算年度脑卒中粗发病率;以第七次全国人口普查数据为标准人口,采用直接标化法计算年龄标化发病率;运用Joinpoint模型分析脑卒中发病率的年度变化百分比(APC)及变化趋势;以年度脑卒中病例的死亡数量(例)与报告发病数量(例)的比值计算死亡发病比。结果:2019年脑卒中粗发病率为468.48/10万,比2015年升高9.41%(APC=2.12%,95%CI:1.43%~2.82%,P_(trend)<0.01),且男性脑卒中粗发病率高于女性,农村高于城市。男性和女性的粗发病率分别升高11.26%(APC=2.53%,95%CI:1.83%~3.24%,P_(trend)<0.01)和7.26%(APC=1.63%,95%CI:0.81%~2.46%,P_(trend)<0.01)。2019年脑卒中年龄标化发病率为523.82/10万,比2015年下降7.47%(APC=-1.72%,95%CI:-3.23%~-0.20%,P_(trend)<0.05),女性脑卒中年龄标化发病率降低9.56%(APC=-2.27%,95%CI:-3.99%~-0.52%,P_(trend)<0.05),城市脑卒中年龄标化发病率降低13.19%(APC=-3.49%,95%CI:-5.34%~-1.61%,P_(trend)<0.05),城市女性脑卒中年龄标化发病率下降幅度(15.82%,APC=-4.27%,95%CI:-6.34%~-2.15%,P_(trend)<0.01)大于城市男性(11.40%,APC=-2.95%,95%CI:-4.56%~-1.31%,P_(trend)<0.05)。随着年龄的增长脑卒中粗发病率升高。相比2015年,2019年45~49岁年龄段的脑卒中粗发病率升高了12.48%(APC=3.18%,95%CI:1.67%~4.72%,P_(trend)<0.01),而80~84岁年龄段则降低15.76%(APC=-4.39%,95%CI:-7.63%~-1.04%,P_(trend)<0.05)。2015~2019年总体脑卒中死亡发病比为0.19。总体死亡发病比的年龄分布呈现“U”型,50~54岁及55~59岁人群的死亡发病比最低(0.10),之后随年龄增长逐渐升高,≥85岁最高(0.45),且各年龄段的城市死亡发病比均低于农村。结论:2015~2019年间监测地区脑卒中发病形势严峻,存在城乡、年Objectives:To present the epidemiological characteristics of stroke incidence and stroke-related mortality among the whole population in national cardiovascular disease surveillance areas from 2015 to 2019.Methods:Data of stroke incidence and stroke-related mortality from 2015 to 2019 were collected from the China Registry of Cardiovascular Events(China RACE),which was established in 2014,covering 100 counties(cities,districts)in 31 provinces in China.The Joinpoint model was used to analyze the annual percentage changes(APC)and trends of stroke incidence rate.The age-standardized incidence rate(ASIR)was calculated using the Seventh National Census data as the standard population.With annual reported stroke events and stroke-related deaths,the mortality to incidence ratio(M/I)were examined.Results:From 2015 to 2019,an increase of 9.41%(APC=2.12%,95%CI:1.43%-2.82%,Ptrend<0.01)resulted in the overall stroke crude incidence rate(CIR)of 468.48/100000 in 2019 among the whole population,with relatively higher in male and in rural area.The more sharply elevating of CIR appeared in males(11.26%[APC=2.53%,95%CI:1.83%-3.24%,Ptrend<0.01])rather than in females(7.26%[APC=1.63%,95%CI:0.81%-2.46%,Ptrend<0.01]).Meanwhile,the general ASIR decreased 7.47%(APC=-1.72%,95%CI:-3.23%--0.20%,Ptrend<0.05),reaching 523.82/100000 in 2019.The females generally showed significant descending trend(9.56%[APC=-2.27%,95%CI:-3.99%--0.52%,Ptrend<0.05]),as well as more reduction than that in the males(15.82%vs.11.40%)in urban area.The crude incidence rate of stroke increased with age.From 2015 to 2019,the CIR in 45-49 age group increased 12.48%(APC=3.18%,95%CI:1.67%-4.72%,Ptrend<0.01),compared with an reduction of 15.76%(APC=-4.39%,95%CI:-7.63%--1.04%,Ptrend<0.05)in 80-84 age group.Over the monitoring years,the overall M/I was 0.19,with an age-specific U-shaped distribution.The lowest of M/I(0.10)appeared in those aged 50-54 and 55-59,while the highest(0.45)detected in those aged 85 and over.The M/I of all age in urban areas were consistently lower

关 键 词：脑卒中 发病率 死亡率 流行病学 

分 类 号：R54[医药卫生—心血管疾病]