20072021年上海市徐汇区户籍居民4种主要慢性病的早死概率

Probability of premature death from 4 major chronic diseases among the registered residents in Xuhui District, Shanghai from 2007 to 2021

  • 摘要:
    目的 了解2007—2021年上海市徐汇区户籍居民主要慢性病死亡现况,分析早死概率及变化趋势,为疾病防控相关政策的制定提供客观依据。
    方法 根据上海市徐汇区2007—2021年户籍人口死亡登记系统数据,计算主要慢性病死亡率、去死因期望寿命、潜在寿命损失年(PYLL)、平均减寿年数(AYLL)、早死率等指标。应用Joinpoint 4.8软件计算早死率年度变化百分比(APC)及其变化趋势。
    结果 2021年上海市徐汇区户籍居民心脑血管疾病、恶性肿瘤、糖尿病与慢性下呼吸道疾病4类主要慢性病的死亡率为767.75/10万,标化死亡率为234.69/10万,占徐汇区居民全死因的85.63%;PYLL、AYLL及PYLL率分别为10 710.00 人·年、1.49年、11.43‰;去除主要慢性病后,期望寿命增加14.91岁;2007—2021年徐汇区户籍居民的慢性病早死率从9.38%降至7.91%(APC=-1.09%,P<0.05)。恶性肿瘤的早死率最高,男性早死率高于女性,下降速度慢于女性。心脑血管疾病、恶性肿瘤及慢性下呼吸道疾病的早死率均呈明显下降趋势(APC=-1.30%、-1.20%、-5.42%,P<0.05),糖尿病早死率呈上升趋势(APC=3.20%,P<0.05)。其中男性糖尿病早死率呈上升趋势(APC=5.15%,P<0.05),女性糖尿病早死率呈下降趋势(APC=-0.76%,P<0.05)。
    结论 心脑血管疾病、恶性肿瘤、糖尿病和慢性下呼吸道疾病是徐汇区户籍居民的主要死因。徐汇区居民主要慢性病早死率处于较低水平,徐汇区慢性病防控取得了一定成效,但要实现《“健康中国”2030规划纲要》的目标,难度仍然较大。因此,须综合开展对烟草使用、有害饮酒、盐摄入、高血压、高血糖和肥胖等危险因素的控制,尤其要加强对男性居民的危险因素控制,以及对恶性肿瘤、心脑血管疾病和糖尿病的早诊早治,落实疾病管理,减少过早死亡。

     

    Abstract:
    Objective To understand the death status of major chronic diseases among the registered residents in Xuhui District, Shanghai from 2007 to 2021, and to analyze the probability and trend of premature death, so as to provide an evidence for the policy-making of disease control and prevention.
    Methods Based on the data from the death registration system of the registered residents in Xuhui District, Shanghai from 2007 to 2021, the mortality rate of major chronic diseases, life expectancy without cause of death, potential years of life lost (PYLL), average years of life lost (AYLL), and premature death rate were calculated. Joinpoint 4.8 software was used to calculate the annual percentage change (APC) of premature death rate and its trend.
    Results In 2021, the mortality rate and standardized mortality rate of four major chronic diseases, namely cardiovascular and cerebrovascular diseases, malignant tumors, diabetes mellitus and chronic lower respiratory diseases among the registered residents in Xuhui District, Shanghai was 767.75/100 000 and 234.69/100 000, respectively, accounting for 85.63% of the total causes of death among the residents in Xuhui District, Shanghai. The PYLL, AYLL and PYLL rate were 10 710.00 person-years, 1.49 years per person, and 11.43‰, respectively. Life expectancy increased by 14.91 years after removing the four major chronic diseases. From 2007 to 2021, the premature death rate of chronic diseases among the registered residents in Xuhui District decreased from 9.38% to 7.91% (APC=-1.09%,P<0.05). Malignant tumors had the highest rate in premature death, and the premature death rate was higher in males than that in females, with a slower rate of decline than in females. Cardiovascular and cerebrovascular diseases, malignant tumors and chronic lower respiratory diseases showed a significant decreasing trend in premature death rate (APC=-1.30%, -1.20%, -5.42%, P<0.05), while diabetes mellitus showed a significant increasing trend in premature death rate (APC=3.20%, P<0.05). There was a significant increasing trend in the rate of premature death from diabetes mellitus in males (APC=5.15%, P<0.05) and a decreasing trend in the rate of premature death from diabetes mellitus in females (APC=-0.76%, P<0.05).
    Conclusion Cardiovascular and cerebrovascular diseases, malignant tumors, diabetes mellitus and chronic lower respiratory diseases are the main causes of death among the registered residents in Xuhui District. The probability of premature death of the residents in Xuhui District from major chronic diseases is at a low level, indicating that the prevention and control of chronic diseases in Xuhui District has achieved some success, but it is still difficult to realize the goals of the Outline of the "Healthy China 2030" Plan. Therefore, it is necessary to comprehensively carry out the control of risk factors such as tobacco use, harmful alcohol consumption, salt intake, hypertension, hyperglycemia and obesity, especially to strengthen the control of risk factors for male residents, as well as early diagnosis and treatment of malignant tumors, cardiovascular and cerebral vascular diseases and diabetes mellitus, and to implement the disease management mechanism to reduce premature death.

     

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