中国15~79岁城乡居民2006—2020年急性心肌梗死死亡趋势年龄-时期-队列分析  

Trends in mortality from acute myocardial infarction among urban and rural residents aged 15-79 years in China from 2006 to 2020:an age-period-cohort analysis

作　　者：刘可 钱东福 LIU Ke;QIAN Dongfu(School of Health Policy and Management,Nanjing Medical University,Nanjing 211166,China;Jiangsu Institute of Health Research,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学医政学院,南京211166 [2]南京医科大学江苏省健康研究院,南京211166

出　　处：《中国公共卫生》2024年第6期681-685,共5页Chinese Journal of Public Health

摘　　要：目的了解中国15~79岁城乡居民2006—2020年急性心肌梗死(AMI)死亡趋势,为制定AMI防治策略和相关公共卫生政策提供参考依据。方法收集2007—2012年《中国卫生统计年鉴》、2013—2017年《中国卫生和计划生育统计年鉴》和2018—2021年《中国卫生健康统计年鉴》中我国15~79岁城乡居民2006—2020年的AMI死亡率相关数据,以2020年全国人口普查数据中的人口构成进行标化率的计算,采用Joinpoint回归模型分析AMI的死亡趋势,并应用年龄-时期-队列模型(APC)分析AMI死亡风险的年龄、时期和出生队列效应。结果中国15~79岁城乡居民、城市居民和农村居民AMI粗死亡率分别从2006年的43.93/10万、25.53/10万和18.40/10万上升至2020年的138.94/10万、60.29/10万和78.65/10万,标化死亡率分别从2006年的48.54/10万、22.67/10万和25.87/10万上升至2020年的91.95/10万、30.60/10万和61.35/10万,标化死亡率的平均年度变化百分比(AAPC)分别为8.94%、3.44%和5.49%(均P<0.05)。APC模型分析结果显示,从年龄效应看,中国15~19岁城乡居民、城市居民和农村居民AMI死亡风险的年龄效应均最低,分别为-2.477(95%CI=-3.413~0.894)、-2.532(95%CI=-3.741~0.901)和-2.413(95%CI=-3.362~0.790),随后不断增加,到75~79岁时城乡居民、城市居民和农村居民AMI死亡风险的年龄效应均达到最高,分别为2.433(95%CI=1.867~2.802)、2.353(95%CI=2.071~2.827)和2.587(95%CI=1.936~2.911);从时期效应看,中国城乡居民、城市居民和农村居民2006—2010年AMI死亡风险的时期效应均最低,分别为-0.497(95%CI=-0.793~-0.139)、-0.234(95%CI=-0.502~-0.119)和-0.619(95%CI=-0.913~-0.205),2016—2020年AMI死亡风险的时期效应均最高,分别为0.591(95%CI=0.074~0.629)、0.616(95%CI=0.293~0.956)和0.570(95%CI=0.119~0.897);从出生队列效应看,中国1929—1933年出生队列城乡居民、城市居民和农村居民AMI死亡风险的出生队列效应均最高,分别为1.630(95%CI=0.849~1.979)、1.713Objective To study the trends in mortality from acute myocardial infarction(AMI)among urban and rural residents aged 15-79 years in China from 2006 to 2020,and to provide a reference for the development of AMI prevention and control strategies.Methods Data on AMI mortality for urban and rural residents aged 15-79 years in China from 2006 to 2020 were collected from the 2007-2012 China Health Statistics Yearbook,the 2013-2017 China Health and Family Planning Statistics Yearbook,and the 2018-2021 China Health Statistics Yearbook.Age-standardized mortality rates for AMI were calculated using the population composition of the 2020 Census.The Joinpoint regression model was used to analyze AMI mortality trends,and the age-period-cohort(APC)model was used to analyze the effects of age,period,and birth cohort on AMI mortality.Results From 2006 to 2020,the crude AMI mortality rate(1/100000)increased for all residents(43.93 to 138.94),urban residents(25.53 to 60.29),and rural residents(18.40 to 78.65);the age-standardized mortality rate(1/100000)also increased for all residents(48.54 to 91.95),urban residents(22.67 to 30.60),and rural residents(25.87 to 61.35),with average annual percentage changes(AAPC)of 8.94%,3.44%,and 5.49%,respectively(all P<0.05).The APC model analysis showed different effects of age,period,and birth cohort on AMI mortality trends in the total population and in subgroups as follows:(1)the age effects were lowest in the total,urban,and rural populations aged 15-19 years,with effect values(95%confidence interval[95%CI])of-2.477(-3.413-0.894),-2.532(-3.741-0.901),and-2.413(-3.362-0.790);the age effect increased continuously with increasing age and was highest in the total,urban,and rural populations aged 75-79 years,with effect values(95%CI)of 2.433(1.867-2.802),2.353(2.071-2.827),and 2.587(1.936-2.911),respectively;(2)the period effects were the lowest for the period of 2006-2010,with the effect values(95%CI)of-0.497(-0.793--0.139),-0.234(-0.502--0.119),and-0.619(-0.913--0.205)for all,urban,and rural p

关 键 词：急性心肌梗死(AMI) 死亡趋势 年龄-时期-队列(APC)模型 城乡居民 中国 

分 类 号：R542.22[医药卫生—心血管疾病]