广西1950~2007年法定传染病发病与死亡分析

目的 了解广西壮族自治区法定传染病长期的发病、死亡趋势,探讨疾病规律,总结防治经验.方法 利用广西1950~2007年法定传染病报告数据,对广西传染病的发生和死亡进行回顾性分析,描述发病水平和死亡水平及变化趋势.结果 50余年来传染病报告发病率和死亡率总体呈下降趋势,发病率报告最高年份是20世纪70年代前期,平均报告发病率为5285.03/10万,最低年份是20世纪90年代后期,平均报告发病率为196.69/10万.报告死亡高峰发生在20世纪60年代后期,最低在90年代后期,最高死亡率是1967年为39.66/10万,最低是1998年为0.62/10万.结论 广西壮族自治区50余年来传染病报告发病率、死亡率发生了根本性的变化,近年传染病呈上升趋势.     

山东省人口1970~1974年、1981~1989年死因趋势分析

通过对山东省1970~1974年、1981~1989年死因资料分析,揭示了山东省人口70年代初期和80年代总死亡水平及死亡谱的变动趋势。近20年呼吸系统疾病死亡率上升了19.21%,居各类死因之首,恶性肿瘤、脑血管病死亡率升高了47.15%和75.31%,由第三、四位死因前移至第二、三位,心脏病死亡率变动较小,死亡位次稳定在第四位,传染病由70年代初期第二位退居至第八位,死亡率下降了78.22%。     

广西1950—2007年法定传染病发生与死亡回顾性研究

目的了解广西法定传染病长期的发病、死亡趋势，探讨疾病规律，总结防治经验。方法采用广西1950—2007年法定传染病报告数据，对广西传染病的发生和死亡进行回顾性研究，描述发病和死亡水平及变化趋势。结果50余年来传染病报告发病率和死亡率总体呈下降趋势，发病率报告最高年份是20世纪70年代前期，平均报告发病率是5285．03／10万，最低年份是20世纪90年代后期，平均报告发病率是196．69／10万。报告死亡高峰发生在20世纪60年代后期，最低在90年代后期，最高死亡率是1967年为39．66／10万，最低是1998年为0．62／10万。结论广西50余年来传染病报告发病率、死亡率发生了根本性的变化，显示了传染病防制工作的成效。传染病疾病谱和死亡谱的变化反映了所采取的防治措施是有效的，但一些古老传染病的发生反映了某些工作上的薄弱，而近年呈上升趋势的传染病也提示了传染病的长期性和复杂性。应加强和提高研究和控制力度，有效地控制传染病。     

中国国民脑血管疾病死亡分析

目的 了解我国城市与农村居民脑血管疾病的危害与死亡特点。方法 根据我国居民病死伤原因资料，对不同性别、年龄、年代，及不同国家地区的脑血管病死亡水平进行对比分析。结果 脑血管病为我国居民主要死因之一，占全死因死亡的20％左右；其中以脑出血死亡为主，城市和农村脑出血死亡分别占脑血管病死亡的61％和73％。男性脑血管病死亡率高于女性；脑血管病死亡率随年龄增加而增加。结论 1989年以来，我国城市居民脑血管病死亡率呈下降趋势，农村则呈上升趋势。     

江苏省溧水县疾病监测点居民1990～2000年恶性肿瘤死亡情况

恶性肿瘤严重威胁居民身体健康，是人群的重要死亡原因之一。为掌握溧水县20世纪90年代恶性肿瘤死亡情况，进一步加强肿瘤的预防研究，降低死亡率，现对该县疾病监测点乡镇1990～2000年恶性肿瘤死亡资料进行统计分析，结果报告如下。     

中年人，警惕突发性胸痛！

众所周知，冠心病已经成为威胁人类健康的头号敌人．．自20世纪50年代以来，人群越心病患病率和死亡率不断上升．在发达国家中趋势尤为显。随着我国人民生活水平的提高，冠心病的发病率和死亡率也呈上升趋势。据1999年的统计，在城市人口死亡原因中占一至三位的疾病分别为心血管疾病、肿瘤和呼吸道疾病。农村则为呼吸道疾病、心血管疾病和肿瘤。     

恶性肿瘤死亡率再敲警钟

为了解21世纪初我国城乡、不同类型地区居民以恶性肿瘤为重点的全部死因的死亡率水平、死因构成及其变化趋势，掌握主要恶性肿瘤死亡的地区与人群分布特征，从2006年开始，卫生部和科技部在全国范围进行了我国第三次居民死亡原因抽样调查。近日发布的调查结果显示，慢性非传染性疾病成为城乡居民死因的主要疾病，恶性肿瘤死亡率属于世界较高水平，且呈持续的增长趋势。     

上海市慢性非传染性疾病流行病学趋势研究:1951～1998年死亡资料分析

目的：研究上海市主要慢性非传染性疾病（慢病）的死亡率的长期时间趋势。方法：上海市死因登记系统自50年代已开始收集人口学资料和死亡资料。死亡率的时间趋势分析采用线性回归统计模型。结果：1998年上海市平均期望寿命增长到77．03岁,居民调查死亡率呈持续下降趋势。前三位 因分别为循环系统疾病,肿瘤,呼吸系统疾病,已占总死亡的75．42％。慢病的死亡顺位在不断提高。慢病的粗死亡率呈逐年上升趋势。但是,上海市慢病的调整死亡率趋势不尽相同,慢性阻塞性肺病的调整死亡率持续下降,糖尿病则持续上升;肿瘤,脑血管病,心血管病调整死亡率则先升后降,与粗死亡率趋势形成明显的剪刀差,转折点分别发生于20世纪70年代中期,80年代末期和90年代初期,分部位的肿瘤中,仅直肠肿瘤和乳腺癌未见明显下降,结论：人口的老龄趋势已是上海市慢病粗死亡率出现上升趋势的主要影响因素。上海市主要慢病的死亡率在经历了近30年的上升趋势后,已出现下降,提示在近20年主要慢病预防控制已取得成效,但并不提示与膳食和行为习惯有关的危险因素正在减少。     

邛崃市疾病监测点1985-1999年意外死亡监测分析

目的 了解邛崃市意外死亡的原因和分析规律。方法 用死亡率变化趋势及标化死亡率的比较。对邛崃市1985-1999年疾病监测点意外死亡资料进行分析。结果 意外死亡年平均标化死亡率83.99/10万，占总死亡人数的12.85%，居全死因的第3位；前3位死因是自杀，淹死，交通事故；意外死亡率90年代较80年代明显上升，90年代是80年代的1.24倍，男性高于女性，男性是女性的1.52倍，且差异均具有显著性；男性前3位死因是淹死，交通事故，自杀，女性前3位死因是自杀，淹死，交通事故；死亡率儿童及老年人较高，青壮年较低。结论 邛崃市15年中意外死亡年平均标化死亡率高于四川省同期水平。且呈上升趋势，提示意外死亡严重危害人群健康和生命，故加强人群意外死亡预防工作实属重要。     

卫生统计年报中住院资料推测人群死因构成及水平的可行性分析

目的 利用1987-2001年全国卫生统计年报中的主要循环系统疾病的医院资料推测人群的死因构成及死因水平的可行性。方法 利用主要的循环系统疾病住院资料的出院病人数、病死率和死因登记资料的死亡率，分别计算城乡不同资料来源的各病种的死因构成。采用Pearson或Spearman法分析两者的相关性，构建回归模型。结果 城市慢性风湿性心脏病、缺血性心脏病和心肌梗塞两变量高度相关，相关系数分别为0．975，0．928和0．904；农村慢性风湿性心脏病、缺血性心脏病、脑血管病和急性心肌梗死也具有高度相关性，相关系数分别为0．875、0．961、0．964和0．907。构建了慢性风湿性心脏病、急性心肌梗死和缺血性心脏病的回归模型。结论 慢性风湿性心脏病、急性心肌梗死和缺血性心脏病医院资料的死因构成与死因登记资料的死因构成两者高度相关。在尚未建立完善死因登记制度的地区，可以考虑利用回归模型推测人群的死因构成以及死因水平。     

Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study

BACKGROUND: Despite increased cardiovascular disease risk factors, migrants to Australia from Mediterranean countries have lower mortality than do native-born Australians. Dietary patterns may contribute to this. OBJECTIVE: The objective was to investigate the relation between dietary patterns and mortality from cardiovascular (CVD) and ischemic heart disease (IHD) in an ethnically diverse population. DESIGN: This was a prospective cohort study (mean follow-up: 10.4 y) of 40 653 volunteers (23 980 women) aged 40-69 y in the Melbourne Collaborative Cohort Study (1990-1994); 24% of the subjects were Mediterranean born. RESULTS: Four dietary factors were identified from a food-frequency questionnaire with the use of principal components analysis. They explained 69% of intake variance and reflected frequent intakes of Mediterranean foods, vegetables, meat, and fresh fruit. The Mediterranean factor was inversely associated with CVD and IHD mortality in models adjusting for diabetes, waist-to-hip ratio, body mass index, and hypertension. For IHD, the hazard ratio (HR) for the highest compared with the lowest quartile of consumption was 0.59 (95% CI: 0.39, 0.89; P for trend = 0.03). Associations persisted in analyses excluding people with prior CVD (HR: 0.51; 95% CI: 0.30, 0.88; P for trend = 0.03). Vegetable and fresh fruit factors were inversely associated with CVD mortality but only among those without prior CVD. HRs (highest compared with lowest quartile) were 0.66 (95% CI: 0.48, 0.92; P for trend = 0.02) for vegetables and 0.69 (95% CI: 0.52, 0.93; P for trend = 0.04) for fresh fruit. The meat factor was not associated with CVD or IHD mortality. CONCLUSION: Our findings suggest that frequent consumption of traditional Mediterranean foods is associated with reduced cardiovascular mortality after controlling for important risk factors and country of birth.     

Changing patterns of ischaemic heart disease mortality in New Jersey 1968-1982, and the relationship with urbanization

Geographical variations in the declining rates of ischaemic heart disease (IHD) mortality may provide clues about various environmental risk factors responsible as a mass influence on the population IHD rate. The rate of IHD decline in 18 of 21 NJ counties was 2 to 45% less than the USA national rate of decline. The overall decline of IHD mortality in New Jersey (NJ) counties lagged significantly (p less than 0.05 to p less than 0.0003) behind the national trend. Age-adjusted mortality rate (AAMR) for IHD in NJ's 21 counties were 4% to 56% higher than the US rates. The IHD mortality rate of 14 of 21 NJ, counties and the entire state were significantly (p less than 0.005 to p less than 0.000001) above the US rate. Highly urbanized, industrialized, and densely populated NJ counties had the highest IHD rates. In these highly urbanized, industrialized and overcrowded NJ counties the AAMR for IHD was significantly higher and the IHD decline was significantly lower than that in the US. There was a significant (p less than 0.02 to p less than 0.00001) inverse association between annual per capita income and IHD rates. These data suggest that a high degree of urbanization, extensive industrialization, high population density and low socioeconomic status were acting as mass influences on the NJ population IHD rate.     

Ischemic heart disease in nuclear workers first employed at the Mayak PA in 1948-1972

Following an earlier study of incidence and mortality of ischemic heart disease (IHD) published in 2010, a second analysis has been conducted based on an extended cohort and five additional years of follow-up. The cohort includes 18,763 workers, of whom 25% were females, first employed at the Mayak PA in 1948-1972 and followed up to the end of 2005. Some of these workers were exposed to external gamma rays only, and others were exposed to a mixture of external gamma-rays and internal alpha-particle radiation. A total of 6,134 cases and 2,629 deaths from IHD were identified in the study cohort. A statistically significant increasing trend was found with total external gamma-ray dose in IHD incidence (ERR/Gy 0.099; 95% CI: 0.045-0.153) after adjusting for non-radiation factors. This value reduced slightly when adjusting for internal liver dose. There was no statistically significant increase trend for internal liver dose in IHD incidence. These findings were consistent with an earlier study. New findings in IHD incidence revealed a statistically significant decrease in IHD incidence among workers exposed to external gamma-rays doses of 0.2-0.5 Gy in relation to the external doses below 0.2 Gy. This decreased risk is heavily influenced by female workers. This finding has never been reported in other studies, and the results should be treated with caution. The findings for IHD mortality are similar to those results in the earlier analysis; there was no statistically significant trend with external gamma-ray dose or for internal liver dose after adjustment for external dose. The risk estimates obtained from these analyses of IHD incidence and mortality in relation to external gamma-rays in the cohort of Mayak workers are generally compatible with those from other large occupational radiation worker studies and the Japanese atomic bomb survivors.     

Mortality from ischaemic heart disease and cerebrovascular disease in Greenland

Mortality 1968-83 from Ischaemic Heart Disease (IHD) and Cerebrovascular Disease (CD) was studied in native Greenlanders. Mortality from IHD was lower in Greenland than in Denmark for both males and females and especially low in Greenlandic settlements. IHD mortality decreased during the period. Mortality from CD was higher in Greenland than in Denmark with no certain time trend. Living conditions, of which a high intake of seafood may be a key factor, and/or a genetic predisposition seem to protect Greenlanders from IHD and to predispose them to CD.     

Competing risks analysis using Markov chains: impact of cerebrovascular and ischaemic heart disease in cancer mortality

BACKGROUND: A decrease in cerebrovascular disease (CVD) and ischaemic heart disease (IHD) mortality can produce an increase in mortality from other causes, even cancer. This problem is called the competing risks problem. METHODS: A Markov chain is used to analyse the interrelation between CVD, IHD and cancer mortalities in Spanish women in 1981 and 1994. We compare the results using two models: discarding CVD and IHD mortality (the elimination model) and substituting CVD and IHD 1981 mortality rates in 1994 figures (the constant model). RESULTS: Removing mortality from CVD and IHD increases cancer mortality rates in women aged > or = 70, and the probability of death from cancer rises from 10.7% to 13.3%. In the second model, the use of CVD and IHD 1981 mortality rates in 1994 data yields slightly lower mortality rates and so the impact of CVD and IHD mortality changes in the period 1981 to 1994 is negligible except in elderly women. CONCLUSIONS: Although IHD and CVD mortality have decreased in all age groups of Spanish women from 1981 to 1994, this has not had a great impact on cancer mortality.     

武汉大气污染与缺血性心脏病死亡关系季节差异

目的 评价大气污染物的短期暴露对居民缺血性心脏病(IHD)死亡的影响及其影响的季节差异。方法 收集湖北省武汉市江岸区2002年1月1日—2010年12月31日IHD死亡监测资料和同期环境监测中心大气污染物浓度数据,应用基于广义相加模型的时间序列分析方法,分别构建全季节模型和分季节模型,定量评价大气污染对居民IHD死亡的影响。结果 4个季节中,大气污染水平和IHD死亡人数均在冬季达到最高,冬季可吸入颗粒物PM₁₀、SO₂和NO₂年均浓度分别为(143.8±70.9)、(71.0±42.4)和(66.5±25.6)μg/m³,IHD日均死亡1.64人。全季节模型中,1 d滞后(Lag1)的PM₁₀浓度每升高10 μg/m³,IHD死亡率增加0.86%(95%CI= 0.22%~1.51%),其他气态污染物SO₂、NO₂与全季节IHD死亡无统计学关联;分季节建模后,PM₁₀、SO₂和NO₂对IHD死亡的影响均出现在冬季,其他季节的影响均无统计学意义;其中,1 d滞后的PM₁₀、SO₂和NO₂ 浓度每升高10 μg/m³,冬季IHD死亡率分别增加1.40%(95%CI=0.58%~2.23%)、1.65%(95%CI=0.28%~3.05%)和3.05%(95%CI=0.92%~5.23%)。结论 武汉市大气污染的短期暴露会引起IHD死亡风险增加,且大气污染对IHD死亡的作用效应呈现一定的季节差异,冬季的影响表现更为明显。     

Incidence and prognosis of ischaemic heart disease with respect to marital status and social class. A national record linkage study.

Increased mortality from ischaemic heart disease (IHD) has been found in previous studies among divorced, widowed, and unskilled middle-aged Finnish men. In this study all cases of IHD in men aged 40-64 during 1972 were analysed by linking death certificates and hospital records (7499 cases with 3136 deaths). Age-adjusted incidence, mortality, and survival rates of the first and third year were calculated by marital status and social class. The highest mortality rate was found among unskilled workers, the highest incidence among widowers and those in the lower professional classes, and the lowest survival rate among divorcees, single persons, and unskilled workers. The ratio of mortality by marital status (1.77) was in part due to survival (ratio 1.44) and in part due to incidence (ratio 1.32). The ratio of mortality by social class (1.44) seemed to be due more to differences in incidence (ratio 1.36) than to differences in survival (ratio 1.18). The distribution of conventional risk factors of IHD by marital status and social class seems to explain only part of the mortality differences.     

Seasonal variation in mortality from ischemic heart disease and cerebrovascular disease in Okinawa and Osaka: the possible role of air temperature

Okinawa is located in a subtropical area and is well-known for low mortality due to ischemic heart disease (IH-D) and cerebrovascular disease (CVD). However, the factors that contribute to these low mortality rates remain unclear. We examined the seasonal variation in the mortality due to IHD and CVD among Okinawa and Osaka residents, aged 45 to 84 years, between 1992 and 1996. In addition, we studied if there was a relationship between the monthly mortality rate from IHD or CVD and the monthly mean daily air temperature in Naha City and Osaka City. Data on the monthly mean daily air temperature was obtained from the meteorological stations in Naha City and Osaka City. Our results showed that there were inverse correlations between the monthly mean daily temperature in a city and each of the monthly mortality from IHD in Okinawa (r=-0.794, p<0.01), the monthly mortality from CVD in Okinawa (r=-0.837, p<0.001), and the monthly mortality from CVD in Osaka (r=-0.954, p<0.001). In Osaka, the monthly mortality rate from IHD was at or near its minimum value when the mean daily temperature was approximately 25 degrees C (in September), and it increased in a linear fashion as the mean monthly temperature fell (r=-0.975, p<0.001). The difference between the monthly mortality from IHD or CVD among the Okinawa and the Osaka residents increased in the winter season in comparison with that in the other seasons, with the exception for IHD in July and in August. These findings indicate that the lower mortality from IHD and CVD in Okinawa is affected, at least in part, by Okinawa's warm winter.     

Ischaemic heart disease mortality and the business cycle in Australia.

Trends in Australian heart disease mortality were assessed for association with the business cycle. Correlation models of mortality and unemployment series were used to test for association. An indicator series of "national stress" was developed. The three series were analyzed in path models to quantify the links between unemployment, national stress, and heart disease. Ischemic heart disease (IHD) mortality and national stress were found to follow the business cycle. The two periods of accelerating IHD mortality coincided with economic recession. The proposed "wave hypothesis" links the trend in IHD mortality to the high unemployment of severe recession. The mortality trend describes a typical epidemic parabolic path from the Great Depression to 1975, with a smaller parabolic trend at the 1961 recession. These findings appear consistent with the hypothesis that heart disease is, to some degree, a point source epidemic arising with periods of severe economic recession. Forecasts under the hypothesis indicate a turning point in the mortality trend between 1976 and 1978. (Am J Public Health 69:772-781, 1979).