2013—2021年山东省滕州市高血压防控对急性心肌梗死死亡率的影响  

Impact of hypertension prevention and control on the mortality rate of acute myocardial infarction in Tengzhou City,Shandong Province from 2013 to 2021

作　　者：徐元杰[1] 廖培超 徐玉銮 程俐[1] 韩金国 叶树军 武宗义[4] 司福中[1] Xu Yuanjie;Liao Peichao;Xu Yuluan;Cheng Li;Han Jinguo;Ye Shujun;Wu Zongyi;Si Fuzhong(Department of Cardiology,Tengzhou City Traditional Chinese Medicine Hospital,Tengzhou 277599,China;Chronic Disease Prevention and Control Department of Tengzhou Center for Disease Control and Prevention,Tengzhou 277599,China;Department of Internal Medicine,Shandong Coal Health School,Xuecheng 250024,China;Department of Cardiology,Tengzhou Central People′s Hospital,Tengzhou 277599,China)

机构地区：[1]滕州市中医医院心内科,滕州277599 [2]滕州市疾病预防控制中心慢病防制科,滕州277599 [3]山东省煤炭卫生学校内科学教研室,薛城250024 [4]滕州市中心人民医院心内科,滕州277599

出　　处：《中华健康管理学杂志》2024年第7期520-528,共9页Chinese Journal of Health Management

基　　金：国家“十二五”重大新药创制科技重大专项(2012ZX09101105)。

摘　　要：目的分析2013—2021年山东省滕州市高血压防控对急性心肌梗死(AMI)死亡率的影响。方法本研究为横断面研究,收集2013年1月1日(滕州市开始高血压防控的时间)至2021年12月31日冠心病信息管理系统AMI死亡病例监测数据,统计AMI死亡率及其变化趋势,分析其在不同特征居民间的分布差异。户籍人口信息来源于滕州市公安局,以2020年全国第7次人口普查数据计算年龄和性别标化死亡率,采用t检验比较血压、检验项目等差异,采用χ^(2)检验比较死亡率差异,采用Cochran-Armitage趋势检验比较死亡率的时间趋势和年龄趋势,分析高血压防控对AMI死亡率的影响。结果滕州市2013—2021年AMI总体粗和标化死亡率由50.87/10万和63.82/10万下降为41.08/10万和38.70/10万(Z=-5.741、-10.884)(均P<0.001),并均于2014年和2017年形成双峰。男性粗和标化死亡率第一峰位于2015年,同比2013年升高25.12%和17.60%,女性位于2014年,同比2013年升高29.56%和24.38%(χ^(2)=13.200、9.065、14.862、12.123)(均P<0.05)。粗和标化死亡率第二峰位于2017年,比2016年男性升高18.17%和17.17%,女性升高25.73%和22.34%(χ^(2)=8.266、9.182、14.066、11.105),标化死亡率男性比女性高15.18%~29.01%(χ^(2)=6.239~19.326)(均P<0.05)。AMI死亡率随年龄增加而升高(Z=35.485~51.308)(P<0.001);55~64岁年龄段男性2015年同比2013年升高64.29%,女性2017年同比2015年升高108.48%,35~44岁年龄段女性2016年同比2015年升高373.51%(χ^(2)=10.751、12.805、4.799),男、女性≥65岁年龄段2021年比2013年分别下降43.51%和41.28%(Z=-7.333、-7.465)(均P<0.05)。城区AMI死亡率2021年比2016年下降76.93%,农村2021年比2017年降低30.28%,两区整体均呈下降趋势(Z=-7.560、-2.398)(均P<0.05)。结论2013—2021年山东省滕州市AMI死亡率呈下降趋势,高血压防控可能是其原因之一;标化死亡率男性高于女性,农村死亡率下降率低于城区,应加强这类人群的AMI一、二级预�Objective To analyze the impact of hypertension prevention and control on the mortality rate of acute myocardial infarction(AMI)in Tengzhou City,Shandong Province from 2013 to 2021.Methods This study was a cross-sectional study.The surveillance data of AMI deaths from January 1,2013(the time when hypertension prevention and control began in Tengzhou)to December 31,2021 were collected in the coronary heart disease information management system,the mortality rate of AMI and its change trend were analyzed,and the distribution differences among residents with different characteristics were analyzed.The registered population information was obtained from Tengzhou Public Security Bureau,and the age and gender standardized mortality rate was calculated based on the data of the 7th national population census in 2020.The t test was used to compare the differences in blood pressure and laboratory items,chi-square test was used to compare the differences in mortality rate,and Cochran-Armitage trend test was used to compare the time trend and age trend of mortality rate,so as to analyze the impact of hypertension prevention and control on the mortality rate of AMI.Results The overall crude and standardized AMI mortality rates in Tengzhou decreased from 50.87/100000 and 63.82/100000 to 41.08/100000 and 38.70/100000 from 2013 to 2021,respectively(Z=-5.741,-10.884,both P<0.001),and double peaks were formed in 2014 and 2017.The first peak of crude and standardized mortality rate was formed in 2015 for males,which was 25.12%and 17.60%higher than that in 2013;and the first peak was formed in 2014 for females,which was 29.56%and 24.38%higher than that in 2013(χ^(2)=13.200,9.065,14.862,12.123)(all P<0.05).The second peaks of crude and standardized mortality were formed in 2017,with an increase of 18.17%and 17.17%for males and 25.73%and 22.34%for females from 2016(χ^(2)=8.266,9.182,14.066,11.105),the standardized mortality rate was 15.18%-29.01%higher in males than that in females(χ^(2)=6.239-19.326)(all P<0.05).The mortality rate

关 键 词：急性心肌梗死 死亡率 人群监测 高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R542.22[医药卫生—内科学]