2015—2019年中国居民缺血和出血性脑卒中发病和死亡特征分析  

Analysis of the incidence and mortality characteristics of ischemic and hemorrhagic stroke among Chinese residents from 2015 to 2019

作　　者：陈晓荣[1] 颜流霞[1] 龙政 厚磊[1] 蔡小宁[1] 王丽敏[1] 吴静[1] Chen Xiaorong;Yan Liuxia;Long Zheng;Hou Lei;Cai Xiaoning;Wang Limin;Wu Jing(National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;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：《中华预防医学杂志》2025年第2期202-208,共7页Chinese Journal of Preventive Medicine

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年中国居民缺血和出血性脑卒中发病、死亡特征及其变化情况。方法:利用覆盖全国31个省份100个县(市、区)的中国心脑血管事件登记系统中2015—2019年缺血、出血性脑卒中发病和死亡数据,以第七次全国人口普查数据为标准人口计算标化发病率;以缺血、出血性脑卒中发病率的比值计算缺血性脑卒中发病比;以死亡数量(例)与报告发病数量(例)的比值计算死亡发病比,并计算出血/缺血性脑卒中死亡发病比的比值( RR)。采用Joinpoint 模型分析卒中发病率的年度变化百分比(APC)及变化趋势。 结果:2015—2019年共累计报告新发脑卒中病例1 354 614例,其中缺血性脑卒中1 077 244例(79.52%),出血性脑卒中277 370例(20.48%);共报告脑卒中死亡病例248 620例,其中缺血性脑卒中死亡病例119 819例(48.19%),出血性脑卒中死亡病例128 801例(51.81%)。2015—2019年各年度的缺血性/出血性脑卒中发病比依次为3.50∶1、3.76∶1、3.63∶1、4.23∶1和4.35∶1。2015—2019年全人群、城乡地区以及男性的缺血性脑卒中标化发病率年度变化趋势均无统计学意义(均 P趋势>0.05),但女性呈下降趋势(APC=-1.02%, P趋势=0.042);全人群、农村、男女性的出血性脑卒中标化发病率均呈下降趋势(均 P趋势<0.05);45~49岁组缺血性脑卒中发病率呈上升趋势(APC=3.82%, P趋势=0.011),70~74岁(APC=-7.37%, P趋势=0.034)、80~84岁(APC=-9.75%, P趋势=0.001)及≥85岁组(APC=-11.22%, P趋势=0.017)出血性脑卒中发病率呈降低趋势。2015—2019年全人群出血性脑卒中 RR值为4.2,城市低于农村(3.8比4.3),55~59岁组城乡 RR差距最大(6.8比9.3)。 结论:2015—2019年间中国居民缺血和出血性脑卒中发病和死亡形势严峻,且存在地区和人群差异。ObjectiveTo analyze the characteristics and changes in incidence and mortality of ischemic and hemorrhagic stroke among Chinese residents from 2015 to 2019.MethodsThe incidence and mortality data of ischemic and hemorrhagic stroke from 2015 to 2019 were collected from the China Registry of Cardiovascular Events(China RACE),which was established in 2014 and covered 100 counties(cities and districts)in 31 provinces in China.The age-standardized incidence rate(ASIR)was calculated using the Seventh National Census data as the standard population.The ratio of the incidence rate of ischemic stroke to hemorrhagic stroke was calculated.The subtype-specific mortality-to-incidence ratio(M/I)was calculated by the ratio of the number of deaths to the reported incidence cases.The relative ratio(RR)of M/I for ischemic to hemorrhagic stroke was calculated.The Joinpoint model was used to analyze the annual percentage change(APC)and trend of the incidence rate of stroke.ResultsFrom 2015 to 2019,a total of 1354614 new stroke cases were reported,including 1077244(79.52%)ischemic stroke and 277370(20.48%)hemorrhagic stroke cases,respectively.A total of 248620 stroke deaths were reported,including 119819(48.19%)ischemic stroke deaths and 128801(51.81%)hemorrhagic stroke deaths.The incidence ratio of ischemic/hemorrhagic stroke from 2015 to 2019 was 3.50∶1,3.76∶1,3.63∶1,4.23∶1,and 4.35∶1,respectively.From 2015 to 2019,there was no statistically significant annual trend of ASIR of ischemic stroke in overall,urban and rural areas and males(P trend>0.05),while there was a downward trend in females(APC=-1.02%,P trend=0.042).The incidence of hemorrhagic stroke in the whole population,rural areas,males and females showed a downward trend(P trend<0.05).Patients aged 45-49 years had an upward trend in the incidence rate of ischemic stroke(APC=3.82%,P trend=0.011),while those aged 70-74 years(APC=-7.37%,P trend=0.034),80-84 years(APC=-9.75%,P trend=0.001)and 85 years and over(APC=-11.22%,P trend=0.017)presented a downward trend in th

关 键 词：缺血性脑卒中 出血性脑卒中 发病率 死亡率 监测 

分 类 号：R74[医药卫生—神经病学与精神病学]