云南省10县（市）2004-2005年城乡居民死亡水平及疾病负担研究

目的利用人群死因回顾调查资料开展居民死亡水平及疾病负担研究，为制定疾病预防控制对策提供科学依据。方法采用居民死亡原因普查方法对2004-2005年2年中10县（市）死亡个案回顾调查，以死亡率和构成比描述居民死亡水平；以伤残调整生命年（DALY）测量疾病负担，死亡损失寿命年（YLL）采用直接法计算，伤残损失寿命年（YLD）采用间接法计算；同时结合人力资本法计算疾病的经济负担。结果云南省10县（市）2004-2005年居民总死亡个案为53293例，城乡居民总死亡率655．61／10万（标化率701．28／10万），城市630．09／10万（标化率685．39／10万），农村720．40／10万（标化率701．28／10万），城乡居民死亡率较高的年龄段为0—1岁（2234．38／10万）和≥55岁（1068．03／10万～24366．08／10万）；全人群前5位死因顺位依次为呼吸系统疾病、损伤和中毒、脑血管病、恶性肿瘤、心脏病。传染性疾病、非传染性疾病、损伤与中毒3大类疾病死亡构成依次为：7．64％（4071／53293）、76．40％（40716／53293）和15．96％（8506／53293）；疾病总负担DALY为198．89／千人，全人群前5位疾病负担顺位依次为：损伤和中毒、神经精神性疾病、呼吸系统疾病、脑血管疾病和传染性疾病。传染性疾病、非传染性疾病和损伤与中毒DALY依次为25．65／千人、127．00／千人和46．24／千人，三者在DALY构成所占比例依次为12．90％、63．85％和23．25％；间接经济负担全人群为69730．84万元，其中传染性疾病、非传染性疾病、损伤与中毒依次为：8992．89万元，44526．20万元和16211．74万元，占间接疾病经济负担构成分别为：12．90％、63．85％和23．25％。结论云南省10县（市）居民死亡原因构成及疾病负担以慢性非传染性疾病为主，慢性非传染性疾病已经成为影响云南省居民健康的主要问题，应适时调整卫生资源，以确保广大群众的健康。

Death rate and disease burden of residents in ten counties of Yunnan Province, 2004-2005

Objective To assess the death rate and disease burden based on data obtained from retrospective survey on cause of death in Yunnan, thus to provide scientific foundation for strategy of disease prevention and control. Methods Mortality and death proportion were used for describe death level. Disability-adjusted life year （DALY） and human capital approach were used to measure disease burden. Years of life lost （YLL） and years lived with disability （YLD） were calculated by direct and indirect measurement respectively. All the data were from the death investigation in 10 urban and rural counties of Yunnan Province in 2004-2005. Results The mortality was 665.61/100 000 persons （standardized mortality 701.28/100 000 persons） in Yunnan, 630. 09/100 000 （ standardized mortality 685.39/100 000） in urban area and 720. 40/100 000 persons （standardized mortality 701.28/100 000） in rural area. Mortalities were higher in people aged 0 - 1 （2 234. 38/100 000 persons） and over 55 years （from 1 068. 03/100 000 to 24 366.08/100 000）. The top five leading causes of death of the residents were respiratory disease, injury and poisoning, cerebrovascular disease, cancer, and cardiac disease. The proportions of death were infectious diseases （7.64%）, non-communicable diseases （76.40%）, injury and poisoning （ 15.96% ） , respectively. The total disease burden was 198. 89/1 000 persons. The orders of top five disease burden were injury and poisoing, neurological and psychiatric diseases, respiratory disease, cerebrovascular disease and infectious diseases. The DALYs were infectious diseases （25.65/1 000 persons, 12. 90% ）, non- communicable diseases （ 127. 00/1 000, 63.85% ）, injury and poisoning （46. 24/1 000, 23.25% ）. The indirect economic burden was 697. 308 4 million Yuan, of which, infectious diseases, non-communicable diseases, injury and poisoning were 89. 928 9 million Yuan, 445. 262 0 million Yuan, and 162. 117 4 million Yuan, respectively. Conehltsion The non-communicable disease is a primary problem in Yunnan nowadays, health resource should be adjusted to suit present circumstances.