2015至2019年中国急性心肌梗死就诊患者病死率分析  

Trends in the case-fatality rates for acute myocardial infarction in China from 2015 to 2019

作　　者：颜流霞[1] 厚磊[1] 蔡小宁[1] 王丽敏[1] 吴静[1] 陈晓荣[1] Yan Liuxia;Hou Lei;Cai Xiaoning;Wang Limin;Wu Jing;Chen Xiaorong(National Center for Chronic and Non-communicable Disease Control and Prevention,Beijing 100050,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

出　　处：《中华心血管病杂志》2024年第12期1405-1411,共7页Chinese Journal of Cardiology

摘　　要：目的分析中国急性心肌梗死(AMI)就诊患者病死率及变化趋势。方法本研究为全人群发病监测。利用"中国居民急性心脑血管事件发病监测"系统,获取2015年1月1日至2019年12月31日监测地区二级及以上医疗机构报告的AMI发病数据,对接"中国人口死亡登记"系统获取患者AMI发病后28 d的转归情况。在总人群及不同性别、年龄组和地区人群中,分别计算AMI病死率、年龄标化病死率及病死率年度变化百分比(APC)。结果共纳入77764例AMI病例。(1)2015至2019年监测地区就诊于二级及以上医疗机构的AMI患者28 d病死率为28.97%(22532/77764),AMI病死率呈下降趋势,年龄标化病死率从2015年的37.53%下降至2019年的18.58%,APC为-14.33%(P=0.018)。(2)监测地区男性和女性AMI病死率均呈下降趋势(P均<0.05)。男性中年龄越小AMI病死率下降幅度越大,以<35岁组和35~44岁组下降幅度最为明显,APC分别为-27.63%(P=0.007)和-22.65%(P=0.004)。女性中各年龄组间AMI病死率下降幅度较为接近。(3)东部和中部监测地区AMI标化病死率均呈下降趋势,APC为-19.22%(P=0.006)和-15.62%(P=0.032),西部地区趋于稳定(P=0.227)。结论2015至2019年我国就诊AMI患者病死率在男、女性和各年龄组中均趋于下降。与东部和中部地区相比,西部地区AMI病死率改善较为有限。Objective To assess the trends in case-fatality rates for acute myocardial infarction(AMI)in China from 2015 to 2019.Methods This study employed a population-based surveillance.Data from the China Registry of Acute Cardiovascular Event(China RACE)were utilized,including AMI cases reported by Grade II and Grade II hospitals at the disease surveillance sites across China from January 1st 2015 to December 31st 2019.The 28-day mortality outcome for reported AMI events was obtained by linking to the national death certificate registry system.The study analyzed the overall and age-standardized case-fatality rates,as well as their annual percent change(APC),during the study period,stratified by gender,age,and region.Results The overall 28-day case fatality rate for AMI was 28.97%(22532/77764)from 2015 to 2019.The age-standardized case-fatality rate for AMI declined significantly from 37.53%in 2015 to 18.58%in 2019,with an APC of-14.33%(P=0.018).We observed a significant downward trend in case-fatality rates of AMI in both genders(both P<0.05).Among males,the case-fatality rate decreased more steeply in younger males compared to elder counterparts.The most marked decreases were seen in males aged<35 years and 35 to 44 years,with APC of-27.63%(P=0.007)and-22.65%(P=0.004),respectively.In females,we observed a relatively stable decrease in case-fatality across age groups.The age-standardized case-fatality rate of AMI in eastern and central China decreased significantly from 2015 to 2019,with the APC of-19.22%(P=0.006)and-15.62%(P=0.032)respectively.However,the age-standardized case-fatality rate of AMI in western China remained stable(P=0.227).Conclusions The prognosis of AMI has considerably improved from 2015 to 2019 in China,regardless of ages and gender.Inequality in case-fatality rates among geographic regions highlights the need for targeted strategies in AMI prevention in western regions.

关 键 词：心肌梗死 病死率 变化趋势 

分 类 号：R542.22[医药卫生—心血管疾病]