1996—2021年上海市闵行区脑血管病疾病负担变化趋势分析

目的分析1996—2021年上海市闵行区脑血管病疾病负担变化趋势，为政府部门针对性制定脑血管病防控策略提供科学依据。方法运用死亡率、早死相关的损失生命年（YLL）、伤残损失健康生命年（YLD）和伤残调整生命年（DALY）等指标评价闵行区脑血管病疾病负担，运用Joinpoint线性回归法分析疾病负担变化趋势，计算不同年份的年度变化百分比（APC）。结果1996—2021年闵行区脑血管病YLL率总体呈下降趋势（全人群:APC=-1.69%，t=-6.9，P<0.05），脑血管病YLD率呈缓慢上升趋势（全人群:APC=1.17%， t=3.5，P<0.05），脑血管病DALY率总体呈下降趋势，2003年起有所波动（全人群:APC=-1.43%，t=-5.6，P<0.05）。男性YLL率高于女性，女性YLD率高于男性，2014年后男性DALY率高于女性。随着年龄增长，脑血管病疾病负担上升，70岁以后疾病负担大幅上升。结论闵行区脑血管病疾病负担处于较高水平，年龄、性别等存在差异，需进一步完善脑血管病筛查、干预和康复措施，减少因脑血管病导致的残疾和过早死亡，降低脑血管病对个人、家庭及社会造成的负担。

Analysis of cerebrovascular disease between 1996 and 2021 in Minhang District of Shanghai

ObjectiveTo analyze the changing trend of cerebrovascular disease burden in Minhang District of Shanghai from 1996 to 2021， and to provide scientific evidence for government to formulate targeted cerebrovascular disease prevention and control strategies.MethodsMortality， years of life lost（YLL）， years of lived with disability（YLD） and disability?adjusted life years（DALY） were used to evaluate the burden of cerebrovascular diseases in Minhang District. Joinpoint linear regression was used to analyze the trend of disease burden.ResultsFrom 1996 to 2021， the YLL rate of cerebrovascular diseases in Minhang District showed a downward trend （whole population: APC=-1.69%， t=-6.9， P<0.05）， The YLD rate of cerebrovascular diseases showed a slow upward trend （whole population: APC=1.17%， t=3.5， P<0.05）， The DALY rate of cerebrovascular diseases showed a downward trend， and fluctuated since 2003 （whole population: APC= -1.43%， t=-5.6， P<0.05）. The YLL rate of cerebrovascular diseases in men was higher than that in women， and the YLD rate of cerebrovascular diseases in women was higher than that in men. After 2014， the DALY of cerebrovascular diseases in men was higher than that in women. With the increase of age， the burden of cerebrovascular diseases increased， and the burden of disease increased significantly in the age group above 70.ConclusionThe burden of cerebrovascular diseases in Minhang District is at a high level， and there are differences in age， gender and other aspects. Measures such as screening， intervention and rehabilitation need to be improved to reduce disability and premature death caused by cerebrovascular diseases and to reduce the burden of cerebrovascular diseases on individuals， families and society.