甘肃省疾病监测点居民健康状况分析

甘肃省疾病监测点１１年共监测人口６６３３３１５人，年平均出生率１８．２０‰，年平均标化死亡率５４５．８０／１０万，男女标化死亡率分别为６０７．５３／１０万和４８３．２０／１０万。主要死因顺位为呼吸系病，循环系病，肿瘤，意外死亡、消化系统、新生儿病、传染病等。     

甘肃省90年代初死因资料分析

为了解甘肃省居民死因情况，应用死亡率，减寿率等指标分析了１９９０￣１９９５年疾病监测死因资料。结果表明，居民平均死亡率５９１．９８／１０万，主要死因顺位为呼吸系病，心脑血管疾病，肿瘤，意外伤害，新生儿病等。     

2009-2011年岱山县海岛居民主要死亡原因与减寿年数分析

目的了解浙江省岱山县海岛地区居民主要死因及居民减寿主要原因,为疾病预防控制提供科学依据。方法应用死亡率、期望寿命和去死因期望寿命、减寿年数和减寿率等指标分析死亡资料。结果 2009-2011年岱山县居民死亡率为761.01/10万,标化死亡率为379.34/10万,死亡率男性高于女性(χ2=70.32,P<0.01);前5位死因顺位依次为恶性肿瘤、呼吸系病、脑血管病、心脏病和损伤中毒;期望寿命79.31岁,去除前5位死因期望寿命分别可增加3.65、2.86、2.27、1.41、1.37岁;减寿年数构成顺位依次为恶性肿瘤、损伤中毒、脑血管病、心脏病和呼吸系病,5种死因占总减寿年数的86.50%,与死因顺位相比,损伤中毒由第5位上升至第2位,而呼吸系病由第2位下降至第5位;平均减寿数顺位依次为损伤中毒、恶性肿瘤、心脏病、脑血管病和呼吸系病。结论岱山县居民主要死亡原因以慢性非传染性疾病为主,损伤中毒和恶性肿瘤是影响低年龄组死亡的主要原因,应根据岱山县居民死因特点制定有效防控干预措施和策略。     

某高校教职工1982～1992年死亡状况分析

采用回顾性调查法分析教职工病伤死亡情况。结果：１９８２年１月１日～１９９２年１２月３１日，１１年间教职工累计人年数为６１５５２人，死亡人１６９人，死亡率为２７４．５６／１０万，男女死亡率分别为４０６．４０／１０万和１６５．９４／１０万，男性明显高于女性；前５位死因顺位是：恶性肿瘤（死亡率为６８．２３／１０万）、呼吸系疾病（死亡率为５５．２４／１０万）、心血管疾病（死亡率为４３．８７／１０万）、脑血管疾病（死亡率为３５．７４／１０万）、损伤和中毒（死亡率为２２．７５／１０万）。教职工平均死亡年龄为６３．２５岁，工人最高（６５．４９岁），干部次之（６３．３２岁）．教师最低（６０．３１岁）。     

上海市徐汇区1999年居民死亡原因及潜在寿命损失分析

对上海市徐汇区居民１９９９年死因回顾资料进行了分析。结果表明：男性的全死因死亡率、潜在寿命损失年（ＰＹＬＬ）均高于女性,男性死亡率死因顺位依次为：肿瘤、循环系、呼吸系、损伤和中毒、传染病;女性死亡率死因顺位依次为：循环系、肿瘤、呼吸系、损伤和中毒、消化系病。与死亡率死因顺位相比,男性损伤和中毒、传染病的ＰＹＬＬ顺位较之提前１个位次。神经系统病、先天异常分别提前５个位次和７个位次;女性的肿瘤、损伤和中毒均提前了１个位次。精神病、传染病分别提前了４个位次和５个位次,该结果提示,循环系、肿瘤、呼吸系病是徐汇区居民的三大主要死因,引起“早死”的疾病是先天异常、传染病、神经系统病。     

1997年沈阳市居民死亡原因及潜在寿命损失分析

对沈阳市居民１９９７年死因回顾调查资料进行分析,其结果表明：男性的全死亡率、潜在寿命损失年（ＰＹＬＩ）均高于女性。男性死亡率死罪顺位依次为：循环系、肿瘤、呼吸系、损伤和中毒及消化系疾病;女性死亡率死因顺位依次为：循环系、肿瘤、呼吸系、内分泌及损伤的中毒。与死亡率死因顺位相比,男性损伤和中毒、消化系疾病的ＰＹＬＩ顺位均较之提前一个位次;女性的先天性异常、损伤和中毒则分别提前６个位次和１个位次。该结果     

赣榆县1996～2002年呼吸系病死亡分析

赣榆县自1996年建立居民死亡登记以来，呼吸系病一直位居死因的第2、3位，为探索该类疾病的预防控制对策，现对1996～2002年全县居民中因该类疾病死亡分布的特点作以研究分析。     

2014年南昌市居民主要死因和期望寿命分析

目的 了解南昌市居民的主要死亡原因及期望寿命,为提高人群的健康水平及制定疾病防控措施提供依据。方法 以2014年南昌市全人群死因监测数据中常驻居民的所有死亡个案为研究对象,使用死亡率、期望寿命等指标对数据进行描述性分析,率的比较采用χ2检验。结果 南昌市居民的粗死亡率为3.16‰(标化率3.54‰),死因以慢性病为主,死亡专率2.64‰,占全死亡人数的83.42%。居民死因顺位前5位依次为循环系病、恶性肿瘤、呼吸系病、伤害以及内分泌营养,占全死因的88.58%。居民的期望寿命为74.28岁(男性73.05岁,女性75.83岁),造成寿命损失的疾病顺位前4位依次为循环系统疾病、恶性肿瘤、伤害以及呼吸系统疾病。结论 南昌市居民的死亡率较低,以心脑血管疾病、恶性肿瘤为代表的慢性病与伤害是影响该市居民健康的主要疾病,应继续加强该区慢性病的综合防治工作,以降低主要慢性病的发病与死亡。     

广西呼吸系统疾病死亡状况分析

根据广西１９９０￣１９９２年抽样１０市县死因调查资料，分析居民呼吸系死亡疾病谱、死亡率和死因构成。结果慢性支气管炎、肺炎和哮喘的死亡率最高，分别占１０万分之８４．５６、３１．６０和６．０２。呼吸系死亡率农村高于城市，经济水平差高于好和中等；文盲高于有文化程度。结论是慢支、肺炎和哮喘是广西居民主要死亡疾病，必须加强防治。     

1991—1193年深圳特区50岁以上人群死因分析

本文对１９９１－１９９３年深圳特区５０岁以上人群常住人口的死亡原因资料进行了分析，三年总死亡率分别是６９．５８％、７６．４３％万和６８．６万。前三位死因是循环系疾病、肿瘤和呼吸系疾病。各年龄段死因顺位稍有所不同，要根据不同年龄段死因变化，及时做好预防措施。     

上海市静安区居民2002—2006年死因分析

目的：通过对静安区2002—2006年人口死亡资料进行统计分析，以期为进一步开展社区卫生工作和相关政策项目的调整提供参考依据。方法：死亡资料来自静安区疾病预防控制中心，死因编码采用ICD-10，疾病大类参照CCD。用Excel建库，统计软件SAS对静安区近5年来的全死因死亡率、死因构成及其顺位进行分析。结果：静安区居民死亡率2006年比2002年下降14．88％，男性高于女性，主要死因构成变化不大，死因前5位的是循环系统疾病、肿瘤、呼吸系统疾病、内分泌、营养及代谢性疾病、损伤和中毒。致死疾病主要为心脑血管疾病、肺癌、慢性下呼吸道疾病、糖尿病及意外伤害等，乳腺癌成为女性恶性肿瘤的主要构成，老年和中年组的糖尿病构成比例较高。减寿率构成前5位是慢性非传染性疾病和损伤中毒。结论：慢性病、肿瘤和意外伤害成为主要死因，慢性非传染性疾病和损伤中毒是居民寿命损失的主要原因，也是静安区面临的主要公共卫生问题，根据疾病发生特点．在防治策略上要有相应的措施。     

湖南省循环系统疾病死亡分析

对湖南省1990～1992年循环系统疾病死亡原因及其分布特征进行分析，并与同一调查范围内70年代资料进行比较．表明该系统疾病死亡率为147．64／10万，占居民总死亡的25．08％，居各系统疾病死亡的首位．其主要死因是脑血管病，占本系统疾病死亡的69．90％，其次是冠心病和高血压（含高血压性心脏病）．主要死因死亡率的分布特征表现为城市与农村有显著差异（男性脑血管病例外），男性显著高于女性，随年龄的增长而升高．与70年代比较，脑血管病、冠心病死亡率上升，而慢性风心病和高心病死亡率下降．     

Evaluation of the quality of cause of death statistics in rural China using verbal autopsies

BACKGROUND: Death registration systems in rural China are in a developmental stage. The Disease Surveillance Points (DSP) system provides the only nationally representative information on causes of death. In this system, there are no standard procedures or instruments for ascertaining causes of death; hence available statistics require careful evaluation before use. AIM: To assess the reliability of data from the DSP. METHODS: 14 DSP sites were selected through stratified sampling, enrolling 2482 deaths registered during June-November 2002. Defined verbal autopsy (VA) procedures were used to derive underlying causes of death. kappa Measures of agreement between VA and registered diagnoses were computed. VA diagnoses were used as references to compute sensitivity and positive predictive values. Finally, patterns of cause-specific discordance between the two data sources were studied. RESULTS: kappa Scores indicate only moderate agreement for chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD). The results also suggest that COPD is undercounted in registration data. A significant degree of cross attribution of cause was found between the two data sources. Overall, the VA was successful in limiting deaths with ill-defined causes to <10%. CONCLUSIONS: Diagnoses based on structured symptom questionnaires in the VA approach seem plausible and reliable as compared with lay-reported diagnoses in registration data. Concerns with attribution of cause of death due to COPD, IHD and tuberculosis in registration data suggest caution in their use for research and health programme purposes. The VA methods tested in this study offer promise for implementation in the routine registration system.     

1956-2010年长沙市尘肺死亡病例调查

目的探讨长沙市尘肺病死亡病例的分布以及死亡原因等流行病学特点,为尘肺病防治提供对策。方法采用回顾性调查方法,对1956-2010年尘肺报告死亡病例,按不同年代、不同死亡年龄、死亡原因等,进行统计分析。结果长沙市累计报告尘肺死亡病例690例,病死率为18.70%;病死率居前3位的尘肺是:矽肺、陶工尘肺、煤工尘肺;引起尘肺病例死亡的前5位原因:肺结核、慢性呼吸衰竭、肺心病、肺部肿瘤、心脑血管疾病。最小死亡年龄24.12岁,最大死亡年龄85.16岁,平均死亡年龄59.86岁。结论预防尘肺病并发症,系统治疗肺结核病、控制肺部感染和慢性呼吸系统疾病,是延长尘肺患者寿命,提高生活质量的主要措施。     

三明市市区2005年居民死亡原因分析

目的探讨三明市市区居民各类疾病死亡原因、分布特征及对居民身体健康的影响,为制订疾病预防控制措施与对策提供科学依据。方法按《疾病和有关健康问题的国际统计分类ICD-10》进行分类。结果市区人群死亡率为335.97/10万,标化死亡率为464.42/10万,死因顺位分别是恶性肿瘤、脑血管病、呼吸系统疾病、心脏病、损伤与中毒。结论重视和加强慢性病的防治已迫在眉睫,在继续做好传染病防治工作的基础上,也应重视慢性非传染性疾病的防治工作。     

浙江省衢州市分枝杆菌菌种鉴定和耐药现状研究

摘要：目的　了解衢州市分枝杆菌菌种分布和耐药情况,为结核病防治提供参考依据。方法　选取２０１４－ ２０１７年衢州市各结核病定点医院上送衢州市人民医院的２３８４株分枝杆菌菌株,采用ＰＮＢ／ＴＣＨ （Ｐ Ｎｉｔｒｏ ｂｅｎｚｏｉｃａｃｉｄ／ｔｈｉｏｐｈｅｎｅ ２ ｃａｒｂｏｘｙｌｉｃａｃｉｄ）生长试验进行菌种鉴定,对四种一线抗结核药物：异烟肼（ｉｓｏｎｉ ａｚｉｄ,ＩＮＨ）、利福平（ｒｉｆａｍｐｉｃｉｎ,ＲＦＰ）、乙胺丁醇（ｅｔｈａｍｂｕｔｏｌ,ＥＭＢ）、链霉素（ｓｔｒｅｐｔｏｍｙｃｉｎ,ＳＭ） 进行耐药性监测。结果　２３８４株分枝杆菌经过鉴定,结核分枝杆菌２２７０株（９５．２２％）,非结核分枝杆菌 （ｎｏｎｔｕｂｅｒｃｕｌｏｓｉｓｍｙｃｏｂａｃｔｅｒｉａｌ,ＮＴＭ）１１４株（４．７８％）;２２７０ 株结核分枝杆菌总耐多药率为５．５１％ ; 复治患者的总耐药率、耐多药率以及对ＩＮＨ 、ＲＦＰ、ＥＭＢ、ＳＭ 任一药物的耐药率均高于初治患者,差异 有统计学意义（均犘＜０．０１）;单一耐药的前３位为ＳＭ＞ＩＮＨ＞ＲＦＰ;多耐药和耐多药的前３位为ＩＮＨ＋ ＲＦＰ ＋ ＳＭ＞ＩＮＨ ＋ ＳＭ＞ＩＮＨ ＋ＲＦＰ。结论　衢州市的复治患者的耐药情况较为严重,需进一步改善结 核病的预防控制工作。 关键词：肺结核;分枝杆菌;ＰＮＢ／ＴＣＨ 生长试验;药敏;耐药率;耐多药 中图分类号：Ｒ１８３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０３ ０１９１ ０４     

贵阳市2002～2004年呼吸系统疾病死亡分析

[目的]分析贵阳市2002～2004年呼吸系统疾病死亡分布,了解贵阳市呼吸系统疾病死亡规律,为贵阳市制定呼吸系统疾病防治提供科学依据.[方法]以办事处(乡、镇)为抽样单位,采取等距、整群随机的方法,抽取全市近1/10人口进行2002～2004年死因回顾性调查.[结果]3年共死亡5489人,其中死于呼吸系统疾病1203人,超过了恶性肿瘤引超死亡,占全死园的21.92%,居全死因顺位第2位.在呼吸系统疾病死亡中,40岁以上占94.01%,60岁以上占80.80%;以慢阻肺为主.[结论]呼吸系统疾病是贵阳市居民死亡重要原因,以幔阻肺为主,主要引起老年人的死亡.新生儿肺炎引起儿童死亡及肺结核、肺癌对贵阳市居民早死影响不容忽视.     

Mortality model based on delays in progression of chronic diseases: alternative to cause elimination model.

For the analysis of the impact of major chronic diseases on a population, a life table model is proposed in which the age at death due to specific cause (chronic disease) is postponed. Even though many of the major causes of death related to intrinsic aging processes are impossible to eliminate, these causes might be significantly delayed or retarded. To illustrate the use of this model, the effects of a delay of 5, 10, and 15 years in deaths due to three chronic degenerative diseases (cancer, ischemic heart disease, and stroke) are calculated for specific race-sex components of the U.S. population in 1969. These calculations show that even moderate delays in the progression of major chronic diseases will yield a sizable portion of the total gain in longevity that would be available if the diseases were totally eliminated. Thus, they demonstrate that a life table model based on cause delay provides a more biomedically plausible representation of the health impact of a chronic disease on a population than does the cause elimination life table model. Additionally, the cause-delay model provides a mechanism for incorporating the likely effects of medical innovation on survival.     

The influence of alcohol abuse as a hidden contributor to mortality

Although only about 2-3 percent of annual deaths are attributed to one of the four underlying causes linked to chronic alcohol use, research results suggest that the impact of alcohol is much greater. The recent issue of mortality multiple cause of death tapes from National Center for Health Statistics permit exploration of associations of chronic alcohol abuse with conditions coded as underlying cause of death and provide leads for case-finding. Data analysis is reported from certificates of resident deaths in the United States in 1978. There are 12 groups of underlying causes for which the percentage of pairings with chronic alcohol abuse ranges from 4-16 percent of the number of deaths from the underlying cause. Age, sex, and metropolitan status of residence are associated with a listing of chronic alcohol abuse among decedents of liver cancer, varicose veins, symptomatic heart disease, septicemia, and respiratory system disease. Planners concerned with secondary prevention can use these clues provided by logistic regression modelling as an aid in case-finding.     

Validation of cause-of-death statistics in urban China

BACKGROUND: National vital registration systems are the principal source of cause specific mortality statistics, and require periodic validation to guide use of their outputs for health policy and programme purposes, and epidemiological research. We report results from a validation of cause of death statistics from health facilities in urban China. METHODS: 2917 deaths from health facilities located in six cities in China constituted the study sample. A reference diagnosis of the underlying cause was derived for each death, based on expert review of available medical records, and compared with that filed at registration. Sensitivity, specificity and positive predictive value were computed for specific causes/cause categories according to the International Classification of Diseases (ICD), including analyses based on quality of evidence scores for each cause. Patterns of misclassification by the registration system were studied for individual causes of death. RESULTS: The registration system had good sensitivity in diagnosing cerebrovascular disease and several site specific cancers (lung, liver, stomach, colorectal, breast and pancreas). Sensitivity was average (50-75%) for some major causes of adult death in China, namely ischaemic heart disease (IHD), chronic obstructive lung disease (COPD), diabetes, and liver and kidney diseases, with compensatory misclassification patterns observed between several of them. Sensitivity was particularly low for hypertensive disease. CONCLUSIONS: Although diagnostic misclassification is not uncommon in urban death registration data, they appear to balance each other at the population level. Compensating misclassification errors suggest that caution is required when drawing conclusions about particular chronic causes of adult death in China. Investment is required to improve the quality of cause attribution for health facility deaths, and to assess the validity of cause attribution for home deaths. Periodic assessments of the quality of cause of death statistics will enhance their usability for health policy and epidemiological research.