2009—2018年上海市某社区呼吸系统疾病死亡趋势及影响因素分析

目的：探讨2009—2018年上海市某社区居民呼吸系统疾病死亡流行病学特征及趋势。方法：利用2009—2018年浦东新区王港社区户籍居民死因监测数据库,采用死亡率、标化死亡率、年度变化百分比（annual percentage change,APC）等指标对呼吸系统疾病相关死亡情况进行分析,并采用率的差别分解法分析人口年龄构成因素和其他危险因素对死亡率差异的贡献。结果：2009—2018年浦东新区某社区因呼吸系统疾病死亡310例,粗死亡率为88.73/10万,标化死亡率为26.89/10万。粗死亡率呈波动态势（APC=-0.82%,Z=-0.687,P=0.512）,合计标化死亡率明显下降（APC=-5.96%,Z=-3.210,P=0.012）。男性呼吸系统疾病粗死亡率和标化死亡率均显著高于女性（P<0.05）。男性和女性粗死亡率无明显变化,标化死亡率明显下降。以2009—2013年各性别呼吸系统疾病粗死亡率为基准,2014—2018年死亡率中由人口因素导致的增长大于其他危险因素。结论：社区呼吸系统疾病的防治需因地制宜,针对人口老龄化采取有针对性的防治措施是有效途径之一。

Mortality trends and quantitative analysis of influencing factors of respiratory diseases among registered population in a community of Shanghai, 2009-2018

Objective:To explore the epidemiological characteristics and analyze the trend of respiratory disease mortality among residents in a community of Shanghai from 2009 to 2018. Methods:According to the mortality data of residents from 2009 to 2018 in a community of Shanghai, crude mortality, standardized mortality rate, annual percent change (APC) were calculated to analyze the status and trends of mortality of respiratory diseases, and the contribution of demographic and non-demographic factors to disease death was calculated by the differential decomposition method. Results:From 2009 to 2018, 310 people died of respiratory disease in a community of Shanghai, with a crude mortality rate of 88.73/100 000 and a standardized mortality rate of 26.89/100 000. The total crude mortality rate of respiratory disease showed a fluctuating trend (APC=-0.82%, Z=-0.687, P=0.512), and the standardized mortality rate by Chinese standard population showed a significant decreasing trend (APC=-5.96%, Z=-3.210, P=0.012). The crude and standardized mortality rates of respiratory disease in males were higher than those in females (P<0.05). The crude mortality rates of respiratory disease in both males and females showed fluctuating trends, but standardized mortality rates showed significantly decreasing trends. Based on the crude mortality rates during 2009-2013, the increase in mortality from 2014 to 2018 due to demographic factors was greater than that due to other risk factors. Conclusions:Prevention and treatment of respiratory disease in community should be tailored according to local conditions. Targeted prevention and treatment measures for aging are one of the effective ways in local areas.