武汉市江岸区2000-2014年脑血管疾病死亡趋势的年龄-时期-队列模型分析

目的 分析2000-2014年武汉市江岸区居民脑血管疾病死亡趋势变化，为制定脑血管疾病预防和控制策略提供相关的科学依据。方法 利用江岸区疾病预防控制中心死因报告数据，采用标化死亡率描述脑血管病的死亡趋势，年龄-时期-队列（age-period-cohort，APC）模型和内源估计算子（intrinsic estimator，IE）算法估计江岸区居民脑血管病死亡风险的年龄效应、时期效应和队列效应。结果 2000-2014年江岸区居民脑血管疾病的死亡率呈现下降趋势；通过APC模型分析脑血管病死亡风险，年龄效应随年龄增加而增大，男性和女性的时期效应和出生队列效应总体上均呈现下降趋势（均有P<0.05）。结论 本研究结果提示武汉市居民脑血管病死亡风险下降，但是疾病负担增加，因此在重视脑血管病二级预防的同时，应把疾病预防的重点放在以社区为基础的一级预防。

Trends in cerebrovascular disease mortality in Jiang'an District,Wuhan City between 2000 and 2014 : an application of APC model

Objective To analyze the trends of cerebrovascular disease mortality in Jiang'an district,Wuhan city during the period 2000-2014, and to provide evidence for developing preventive strategies. Methods The mortality data were obtained from Jiang'an center for disease control and prevention. Trend in age standardized mortality rate was estimated. Age-period-cohort (APC) model and intrinsic estimator (IE) were applied to assess the effects of age, period and birth cohort on the risk of cerebrovascular mortality. Results The mortality rates of cerebrovascular disease decreased significantly across the period 2000-2014. APC model indicated the mortality risk increased with age, and decreased with period and birth cohort both in men and women (all P<0.05). Conclusions The results suggested that the burden of cerebrovascular disease were increasing despite a decreasing trend in mortality rate. Therefore, disease prevention should focus on community-based primary prevention.