2008-2018年天津市慢病示范区期望寿命与主要慢病死亡水平分析

张爽 张辉 沈成凤 王冲 孙坤 王卓 宋桂德 王德征 江国虹

引用本文: 张爽, 张辉, 沈成凤, 王冲, 孙坤, 王卓, 宋桂德, 王德征, 江国虹. 2008-2018年天津市慢病示范区期望寿命与主要慢性病死亡水平分析[J]. 疾病监测. DOI: 10.3784/j.issn.1003-9961.2020.06.009 shu
Citation:  Shuang Zhang, Hui Zhang, Chengfeng Shen, Chong Wang, Kun Sun, Zhuo Wang, Guide Song, Dezheng Wang and Guohong Jiang. Life expectancy and mortality rates of major chronic disease in demonstration area of Tianjin, 2008–2018[J]. Disease Surveillance. DOI: 10.3784/j.issn.1003-9961.2020.06.009 shu

2008-2018年天津市慢病示范区期望寿命与主要慢病死亡水平分析

    作者简介: 张爽,女,天津市人,医师,硕士,现从事慢性病预防控制工作,Email:zhangshuang890120@163.com;
    通信作者: 王德征, wangdezheng1001@163.com
摘要: 目的分析2008 — 2018年天津市慢病示范区期望寿命与主要慢性病死亡水平,评估慢病示范区的创建成效。方法采用2008 — 2018年天津市疾病预防控制中心收集的天津市全人口全死因监测数据,对比示范区、非示范区和全市居民在期望寿命、全死因和主要慢性病(心脑血管疾病、恶性肿瘤、糖尿病和慢性下呼吸道疾病)死亡水平的差异。 户籍人口数据来源于天津市公安局。 分析指标包括粗死亡率、标化死亡率和期望寿命、年度变化百分比(APC),并进行统计学检验。结果2008 — 2018年,天津市慢病示范区户籍居民的期望寿命每年均高于同期非示范区,示范区居民的期望寿命由2008年的81.48岁上升至2018年的82.38岁(APC=0.19, P<0.05)。 示范区居民的全死因粗死亡率无变化趋势,同期非示范区和全市均呈上升趋势。 经标准人口构成调整后,示范区、非示范区及全市居民的全死因标化死亡率均无变化趋势。 示范区急性心肌梗死、慢性下呼吸道疾病和肝癌的粗死亡率和标化死亡率呈下降趋势,下降幅度大于非示范区;示范区女性乳腺癌、男性糖尿病死亡水平的上升幅度小于非示范区和全市;示范区大肠癌死亡水平的上升幅度大于非示范区和全市。结论天津市慢病示范区的建设已经初显成效,各示范区不断探索慢病防控新模式,为全市积累有益经验,整体带动全市慢病防治管理水平的提升。

English

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  • 表 1  2008-2018年天津市示范区、非示范区和全市居民期望寿命(岁)

    Table 1.  Life expectancy of demonstration and non-demonstration areas in Tianjin, 2008–2018(year)

    年份 示范区 非示范区 全市
    合计 合计 合计
    2008 79.66 83.44 81.48 76.88 81.70 79.22 78.53 81.10 79.79
    2009 79.66 83.71 81.64 78.03 82.26 80.09 78.65 82.80 80.65
    2010 78.68 82.66 80.64 77.96 81.99 79.92 78.32 82.32 80.27
    2011 79.59 83.55 81.54 79.19 83.35 81.22 79.45 83.56 81.46
    2012 79.27 83.06 81.13 77.60 82.07 79.77 79.09 83.41 81.19
    2013 79.61 83.38 81.47 77.91 82.12 79.96 79.11 83.41 81.20
    2014 79.68 83.81 81.71 78.73 82.97 80.80 79.02 83.23 81.08
    2015 80.53 84.40 82.43 78.82 82.95 80.83 79.35 83.40 81.33
    2016 81.59 85.12 83.33 79.27 83.38 81.27 79.91 83.86 81.84
    2017 80.01 84.20 82.08 78.12 82.49 80.26 79.72 83.72 81.68
    2018 80.31 84.51 82.38 78.64 83.19 80.87 79.54 83.91 81.69
    APC(%)
    (95%CI
    0.18a
    (0.01~0.34)
    0.19a
    (0.06~0.32)
    0.19a
    (0.04~0.33)
    0.16
    (−0.02~0.33)
    0.14
    (0.01~0.27)
    0.15a
    (0.00~0.30)
    0.16a
    (0.08~0.24)
    0.24a
    (0.10~0.38)
    0.20a
    (0.11~0.30)
      注:APC. 年度变化百分比;a. P<0.05
    下载: 导出CSV

    表 2  2008-2018年天津市示范区、非示范区和全市居民全死因及主要慢性病粗死亡率(/10万)

    Table 2.  Crude mortality rates of all causes death and main chronic diseases of demonstration and non-demonstration areas in Tianjin, 2008–2018(/100 000)

    年份 示范区 非示范区 全市
    全死因 心脏病 脑血
    管病
    糖尿病 慢性下呼吸道疾病 全死因 心脏病 脑血
    管病
    糖尿病 慢性下呼吸道疾病 全死因 心脏病 脑血
    管病
    糖尿病 慢性下呼吸道疾病
    2008 639.24 174.98 140.65 21.66 25.87 675.25 188.80 175.16 17.90 46.12 664.16 184.55 164.54 19.06 39.89
    2009 656.36 187.58 143.88 20.38 24.31 669.46 196.77 168.74 17.40 35.95 665.42 193.93 161.07 18.32 32.36
    2010 679.57 200.76 145.82 19.07 22.70 702.24 212.02 179.34 19.17 35.62 695.23 208.54 168.98 19.14 31.63
    2011 632.29 186.35 124.65 17.97 18.10 672.32 207.94 164.65 17.46 33.56 659.88 201.23 152.22 17.61 28.76
    2012 659.59 206.31 133.00 18.08 19.57 706.60 224.24 171.76 19.01 33.92 697.18 221.07 160.90 18.92 29.72
    2013 662.91 203.23 132.42 18.63 15.66 724.20 239.78 173.37 19.44 28.96 709.06 229.61 161.27 19.30 24.87
    2014 684.49 210.74 130.19 18.92 15.49 717.32 228.05 168.76 19.93 30.72 707.08 222.65 156.73 19.61 25.97
    2015 670.52 194.13 130.08 20.03 18.76 734.15 214.42 178.32 22.15 36.72 713.88 207.99 162.83 21.48 30.95
    2016 659.91 187.03 136.11 23.14 20.07 748.12 214.88 182.01 26.97 35.13 719.54 205.86 167.14 25.73 30.25
    2017 665.71 195.38 133.63 22.59 18.59 764.12 220.99 179.77 24.84 32.32 732.04 212.65 164.73 24.10 27.85
    2018 656.03 187.08 130.41 25.81 17.69 744.46 220.44 168.34 25.00 30.05 715.35 209.45 155.85 25.27 25.98
    下载: 导出CSV

    表 3  2008-2018年天津市示范区、非示范区和全市居民全死因及主要慢性病死亡水平变化趋势

    Table 3.  Mortality trends of all causes death and main chronic diseases of demonstration and non-demonstration areas in Tianjin, 2008–2018

    全死因及主要慢性病 示范区 非示范区 全市
    粗死亡率 标化死亡率 粗死亡率 标化死亡率 粗死亡率 标化死亡率
    全死因 0.22
    (−0.28~0.73)
    −1.14
    (−2.82~0.58)
    1.28a
    (0.88~1.68)
    −0.54
    (−2.47~1.43)
    0.93a
    (0.54~1.33)
    −0.71
    (−2.54~1.16)
    心脏病 0.32
    (−0.92~1.57)
    −1.10
    (−3.01~0.85)
    1.18
    (−0.06~2.44)
    −0.62
    (−2.65~1.45)
    0.89
    (−0.38~2.17)
    −0.74
    (−2.74~1.30)
    急性心肌梗死 −5.36a
    (−7.45~−3.22)
    −6.27a
    (−8.55~−3.94)
    −4.02a
    (−6.93~−1.01)
    −5.41a
    (−8.33~−2.41)
    −4.42a
    (−7.08~−1.68)
    −5.63a
    (−8.38~−2.79)
    脑血管病 −0.77
    (−1.67~0.13)
    −1.94
    (−4.09~0.25)
    0.22
    (−0.50~0.95)
    −1.33
    (−3.69~1.08)
    −0.10
    (−0.79~0.60)
    −1.49
    (−3.75~0.82)
    糖尿病 2.06
    (−0.10~4.26)
    0.72
    (−2.43~3.97)
    4.44a
    (2.79~6.11)
    2.75
    (−0.78~6.40)
    3.67a
    (2.07~5.29)
    2.10
    (−1.19~5.50)
    慢性下呼吸道疾病 −3.37a
    (−5.90~−0.78)
    −4.68a
    (−8.15~−1.08)
    −2.48a
    (−4.70~−0.22)
    −3.97a
    (−7.41~−0.40)
    −2.78a
    (−4.91~−0.59)
    −4.13a
    (−7.39~−0.75)
    恶性肿瘤 0.85a
    (0.15~1.55)
    −0.29
    (−1.99~1.43)
    2.29a
    (1.55~3.05)
    0.49
    (−1.56~2.59)
    1.81a
    (1.24~2.38)
    0.25
    (−1.62~2.15)
    大肠癌 4.75a
    (3.20~6.33)
    3.59a
    (1.19~6.05)
    4.56a
    (3.59~5.54)
    2.40
    (−0.14~5.00)
    4.64a
    (3.73~5.55)
    2.82a
    (0.47~5.23)
    肝癌 −2.26a
    (−3.51~−0.99)
    −3.21a
    (−5.24~−1.14)
    −0.98a
    (−1.91~−0.04)
    −2.67a
    (−4.66~−0.63)
    −1.40a
    (−2.17~−0.63)
    −2.82a
    (−4.65~−0.95)
    肺癌 −0.15
    (−1.37~1.09)
    −1.30
    (−3.08~0.52)
    2.25a
    (1.60~2.91)
    0.30
    (−1.63~2.26)
    1.44a
    (0.75~2.14)
    −0.23
    (−2.01~1.58)
    女性乳腺癌 2.18a
    (0.24~4.17)
    1.44
    (−0.67~3.60)
    4.52a
    (2.17~6.93)
    3.17a
    (0.20~6.23)
    3.75a
    (1.94~5.58)
    2.59a
    (0.28~4.96)
      注:括号外数字为APC值(年度变化百分比,%),括号内数字为APC值的95%可信区间;a. P<0.05
    下载: 导出CSV

    表 4  2008-2018年天津市示范区、非示范区和全市居民恶性肿瘤粗死亡率(/10万)

    Table 4.  Crude mortality rates of all causes death and main chronic diseases of demonstration and non-demonstration areas in Tianjin, 2008–2018(/100 000)

    年份 示范区 非示范区 全市
    恶性
    肿瘤
    大肠癌 肝癌 肺癌 女性
    乳腺癌
    恶性
    肿瘤
    大肠癌 肝癌 肺癌 女性
    乳腺癌
    恶性
    肿瘤
    大肠癌 肝癌 肺癌 女性
    乳腺癌
    2008 165.98 10.92 21.90 62.90 9.90 146.92 9.89 20.25 54.70 7.77 152.79 10.21 20.76 57.22 8.42
    2009 175.17 10.34 20.95 70.03 11.24 149.49 9.77 18.65 56.71 9.87 157.42 9.95 19.36 60.82 10.29
    2010 179.16 11.30 22.70 69.90 11.17 149.95 9.65 19.87 57.78 9.44 158.98 10.16 20.75 61.53 9.98
    2011 170.69 11.50 20.99 66.09 11.65 143.07 9.78 18.20 54.36 8.29 151.65 10.32 19.07 58.00 9.34
    2012 169.36 11.31 22.78 64.88 8.71 148.51 10.29 17.84 58.03 9.58 155.64 10.62 19.42 60.39 9.35
    2013 177.40 13.99 19.11 69.63 11.61 153.75 11.08 17.58 60.43 8.53 162.46 12.06 18.22 63.73 9.63
    2014 186.17 14.13 19.71 73.74 10.80 158.57 11.46 17.12 62.41 9.76 167.18 12.30 17.93 65.94 10.08
    2015 188.55 15.73 20.06 71.29 12.34 163.80 12.35 17.81 63.59 12.03 171.79 13.45 18.54 66.07 12.13
    2016 182.36 15.37 18.77 65.57 11.56 171.68 13.41 17.97 64.77 11.56 175.14 14.05 18.23 65.03 11.56
    2017 185.91 16.22 19.29 66.23 13.11 180.75 13.59 18.80 69.03 13.68 182.43 14.45 18.96 68.11 13.49
    2018 177.98 14.94 16.37 62.48 12.96 177.83 14.53 17.62 65.80 11.87 177.88 14.66 17.21 64.71 12.23
    下载: 导出CSV

    表 5  2008-2018年天津市示范区、非示范区和全市居民全死因及主要慢性病死亡水平变化趋势(分性别)

    Table 5.  Mortality trends of all causes death and main chronic diseases of demonstration and non-demonstration areas in Tianjin, 2008–2018(Grouped by gender)

    全死因及主要慢性病 示范区 非示范区 全市
    粗死亡率 标化死亡率 粗死亡率 标化死亡率 粗死亡率 标化死亡率
    全死因0.32
    (−0.18~0.82)
    0.13
    (−0.41~0.68)
    −0.85
    (−2.59~0.93)
    −1.40
    (−3.05~0.28)
    1.41a
    (1.03~1.79)
    1.13a
    (0.68~1.59)
    −0.32
    (−2.31~1.71)
    −0.75
    (−2.65~1.19)
    1.06a
    (0.69~1.42)
    0.80a
    (0.34~1.26)
    −0.46
    (−2.33~1.45)
    −0.94
    (−2.75~0.91)
    心脏病 0.19
    (−0.93~1.33)
    0.47
    (−0.92~1.88)
    −0.93
    (−2.85~1.03)
    −1.20
    (−3.14~0.78)
    1.08
    (−0.22~2.38)
    1.30a
    (0.08~2.54)
    −0.54
    (−2.53~1.48)
    −0.62
    (−2.72~1.52)
    0.79
    (−0.47~2.05)
    1.02
    (−0.28~2.33)
    −0.63
    (−2.59~1.38)
    −0.78
    (−2.83~1.32)
    急性心肌梗死 −5.14a
    (−7.14~−3.10)
    −5.61a
    (−7.90~−3.25)
    −5.86a
    (−8.13~−3.54)
    −6.75a
    (−9.17~−4.26)
    −4.10a
    (−6.95~−1.16)
    −3.90a
    (−6.90~−0.80)
    −5.27a
    (−8.15~−2.31)
    −5.47a
    (−8.46~−2.38)
    −4.41a
    (−6.96~−1.79)
    −4.41a
    (−7.22~−1.52)
    −5.40a
    (−8.07~−2.64)
    −5.81a
    (−8.69~−2.83)
    脑血管病 −0.51
    (−1.39~0.38)
    −1.09a
    (−2.06~−0.10)
    −1.39
    (−3.68~0.95)
    −2.52a
    (−4.56~−0.43)
    0.49
    (−0.25~1.24)
    −0.10
    (−0.84~0.65)
    −0.94
    (−3.43~1.62)
    −1.79
    (−4.02~0.50)
    0.17
    (−0.52~0.86)
    −0.42
    (−1.15~0.31)
    −1.04
    (−3.43~1.41)
    −1.99
    (−4.13~0.19)
    糖尿病 4.04a
    (1.76~6.37)
    0.13
    (−2.18~2.50)
    3.22a
    (0.21~6.33)
    −1.64
    (−5.05~1.89)
    6.46a
    (4.29~8.67)
    2.66a
    (1.14~4.21)
    5.10a
    (0.84~9.54)
    0.78
    (−2.19~3.84)
    5.66a
    (3.81~7.54)
    1.88a
    (0.35~3.44)
    4.49a
    (0.82~8.30)
    0.05
    (−2.89~3.09)
    慢性下呼吸道疾病 −2.55
    (−5.14~0.10)
    −4.12a
    (−6.90~−1.27)
    −3.72
    (−7.49~0.20)
    −5.50a
    (−8.96~−1.90)
    −1.63
    (−4.06~0.86)
    −3.27a
    (−5.35~−1.15)
    −2.80
    (−6.63~1.18)
    −4.90a
    (−8.05~−1.65)
    −1.93
    (−4.23~0.43)
    −3.56a
    (−5.63~−1.45)
    −2.96
    (−6.57~0.79)
    −5.08a
    (−8.12~−1.93)
    恶性肿瘤 1.07a
    (0.25~1.89)
    0.60
    (−0.12~1.32)
    −0.03
    (−1.75~1.71)
    −0.55
    (−2.31~1.24)
    2.56a
    (1.71~3.41)
    1.97a
    (1.22~2.72)
    0.70
    (−1.51~2.97)
    0.27
    (−1.68~2.25)
    2.06a
    (1.45~2.67)
    1.51a
    (0.89~2.13)
    0.48
    (−1.46~2.46)
    0.01
    (−1.82~1.87)
    大肠癌 5.20a
    (2.61~7.86)
    4.21a
    (3.53~4.90)
    4.08a
    (0.74~7.53)
    3.10a
    (1.08~5.17)
    5.30a
    (4.31~6.30)
    3.63a
    (2.10~5.18)
    3.37a
    (0.97~5.83)
    1.30
    (−1.69~4.39)
    5.26a
    (4.36~6.18)
    3.86a
    (2.78~4.96)
    3.60a
    (1.32~5.93)
    1.94
    (−0.60~4.54)
    肝癌 −2.12a
    (−3.32~−0.92)
    −2.44
    (−5.12~0.31)
    −2.96a
    (−5.24~−0.62)
    −3.62a
    (−6.23~−0.93)
    −0.83
    (−1.85~0.20)
    −1.19
    (−2.62~0.26)
    −2.48a
    (−4.58~−0.34)
    −2.94a
    (−5.15~−0.67)
    −1.26a
    (−1.97~−0.56)
    −1.59a
    (−3.08~−0.08)
    −2.61a
    (−4.57~−0.61)
    −3.14a
    (−5.08~−1.16)
    肺癌 0.43
    (−0.82~1.69)
    −0.91
    (−2.29~0.50)
    −0.54
    (−2.29~1.25)
    −2.20a
    (−4.20~−0.16)
    2.84a
    (2.07~3.61)
    1.44a
    (0.73~2.16)
    0.92
    (−1.21~3.09)
    −0.49
    (−2.25~1.30)
    2.03a
    (1.32~2.75)
    0.63
    (−0.17~1.45)
    0.45
    (−1.39~2.33)
    −1.06
    (−2.82~0.73)
    女性乳腺癌 / 2.18a
    (0.24~4.17)
    / 1.44
    (−0.67~3.60)
    / 4.52a
    (2.17~6.93)
    / 3.17a
    (0.20~6.23)
    / 3.75a
    (1.94~5.58)
    / 2.59a
    (0.28~4.96)
      注:括号外数字为APC值(年度变化百分比,%),括号内数字为APC值的95%可信区间;a. P<0.05
    下载: 导出CSV
  • 2020-0126_2008-2018年天津市慢病示范区期望寿命与主要慢性病死亡水平分析.docx

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  • 通信作者:  王德征, wangdezheng1001@163.com
  • 收稿日期:  2020-04-09
  • 网络出版日期:  2020-05-20
  • 刊出日期:  2020-06-01
通信作者: 陈斌, bchen63@163.com
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