2004—2015年中国循环系统疾病死亡谱特征分析

背景 循环系统疾病中的心脑血管疾病已成为影响中国人寿命的"第一杀手"，患病率和死亡率仍处于上升阶段。揭示循环系统疾病城乡别、性别、地区别死因顺序及其变化趋势，将为预防和控制循环系统疾病的发生发展提供科学依据。 目的 分析我国2004—2015年循环系统疾病中以心脑血管为主的疾病死亡谱特征，即城乡别、性别、地区别死因顺序及其变化趋势。 方法 利用2004—2015年"全国疾病监测系统死因监测数据集"所定义的"循环系统疾病"资料，选取其中各类别疾病的死亡数和死亡率资料，应用SPSS 13.0统计软件，采用χ2检验方法分析各类别循环系统疾病的城乡别、性别、地区别死亡率的差异及变化趋势。 结果 2004—2013年各年的死因顺位排序为脑血管病→缺血性心脏病→循环系统的其他疾病→高血压心脏病/肾脏病→风湿热和风湿性心脏病；2014—2015年各年死因顺位排序为脑血管病→缺血性心脏病→高血压心脏病/肾脏病→循环系统的其他疾病→风湿热和风湿性心脏病。2006—2015年，脑血管病、缺血性心脏病死亡率呈逐年上升趋势；2004—2015年，高血压心脏病/肾脏病死亡率逐年缓慢上升；风湿热和风湿性心脏病死亡率各年变化不大；循环系统的其他疾病死亡率呈双波浪变化，其中2006年和2013年为波峰。城乡别死亡率：脑血管病各年差异均有统计学意义（P<0.05），风湿热和风湿性心脏病除2006、2015年外，高血压心脏病/肾脏病除2005年外，缺血性心脏病除2015年外，循环系统的其他疾病除2004、2005、2011、2012年外，其余年份间差异均有统计学意义（P<0.05）。性别死亡率：各年份风湿热和风湿性心脏病、缺血性心脏病和脑血管病死亡率性别差异均有统计学意义（P<0.05），循环系统的其他疾病除2005年外，其余各年性别差异有统计学意义（P<0.05），高血压心脏病/肾脏病死亡率仅2005年和2015年性别差异有统计学意义（P<0.05）。地区别死亡率：各年份各类别疾病死亡率地区别差异均有统计学意义（P<0.05）。 结论 循环系统疾病死亡率具有明显的城乡别、性别、地区别差异。缺血性心脏病城市高发，其他各类疾病乡村高发；女性风湿热和风湿性心脏病高发，其他各类疾病均为男性高发；风湿热和风湿性心脏病、高血压心脏病/肾脏病、缺血性心脏病、脑血管病、循环系统的其他疾病死亡率地区别差异明显，应根据地区别的差异确定不同的循环系统疾病的防治重点和采取不同的防治措施。 该文的微信推文请扫描下方二维码查看！

Spectrum of Mortality from Circulatory Diseases in China from 2004 to 2015

Background Two circulatory diseases,cardiovascular and cerebrovascular diseases have become the leading death causes in China,and their morbidity and mortality are still rising.Revealing the urban/rural-specific,gender-specific and region-specific differences in the order of circulatory diseases ranked by mortality and its changing trend will provide a scientific basis for the prevention and control of circulatory diseases.Objective To analyze the spectrum of mortality from circulatory diseases ranked by mortality,mainly cardiovascular and cerebrovascular diseases,in China from 2004 to 2015,by areas(urban/rural),sex and region and its changing trend.Methods Information about deaths and mortality due to circulatory diseases stemmed from the data of circulatory disease from 2004 to 2015 defined by National Disease Surveillance System Cause-of-Death Surveillance Data Set.The urban/rural-specific,gender-specific and region-specific differences in the mortality from circulatory diseases and their changing trend were analyzed with χ² test by SPSS 13.0.Results During 2004 to 2013,the six circulatory diseases leading to deaths ranked by mortality in a descending order were:cerebrovascular disease,ischemic heart disease,other circulatory diseases,hypertensive heart disease/kidney disease,rheumatic fever and rheumatic heart disease.And the order of these diseases from 2014-2015 was:cerebrovascular disease,ischemic heart disease,hypertensive heart disease/kidney disease,other circulatory diseases,rheumatic fever and rheumatic heart disease.From 2006 to 2015,the mortality of cerebrovascular and ischemic heart diseases increased year by year.From 2004 to 2015,the mortality of hypertensive heart disease/kidney disease increased slowly year by year.There was no significant change in the mortality of rheumatic fever and rheumatic heart disease but a double wave change in the mortality of other circulatory diseases with peaks in 2006 and 2013.The urban/rural-specific mortality:the difference was statistically significant for cerebrovascular disease each year,for rheumatic fever and rheumatic heart disease each year except in 2006 and 2015,for hypertensive heart disease/kidney disease each year except in 2005,for ischemic heart disease each year except in 2015,and for other diseases of the circulatory system each year except in 2004,2005,2011 and 2012(P<0.05).The gender-specific mortality:the difference was statistically significant for rheumatic fever and rheumatic heart disease,ischemic heart disease and cerebrovascular disease each year,for other diseases of the circulatory system each year except in 2005,and for hypertensive heart disease/kidney disease only in 2005 and 2015(P<0.05).The region-specific mortality:the difference was statistically significant for each disease in each year of the period(P<0.05).Conclusion There were extremely significant urban/rural-specific,gender-specific and region-specific differences in the mortality of circulatory diseases.The incidence of ischemic heart disease was high in urban areas,while that of other circulatory diseases was high in rural areas.The incidence of rheumatic fever and rheumatic heart disease was high for females,while that of other circulatory diseases was high in males.The region-specific mortality difference was statistically significant for rheumatic fever and rheumatic heart disease,hypertensive heart disease/kidney disease,ischemic heart disease and cerebrovascular disease as well as other circulatory diseases.Therefore,prevention and treatment priorities for circulatory diseases should be determined and targeted interventions should be delivered according to region-specific differences.