2010和2018年北京市户籍居民脑血管病疾病负担比较

Comparison of disease burden of cerebrovascular disease in local residents in Beijing, 2010 and 2018

  • 摘要:
    目的  比较2010年和2018年北京市户籍居民脑血管病疾病负担,分析年度变化情况。
    方法  利用2010—2018年北京市户籍居民脑血管病死因监测数据,测算早死所致寿命损失年(YLL),采用间接法测算伤残所致寿命损失年(YLD)和伤残调整寿命年(DALY)等指标。
    结果  2018年北京市户籍居民脑血管病YLL率(2341.69/10万)较2010年(2 798.44/10万)下降了16.32%,标化YLL率(1278.97/10万)较2010年(1 801.24/10万)下降了29.00%;2018年YLD率(680.27/10万)较2010年(580.95/10万)上升了17.10%,标化YLD率(402.06/10万)较2010年(370.64/10万)上升了8.48%;2018年DALY率(3 021.96/10万)较2010年(3 379.39/10万)下降了10.58%,标化DALY率(1 681.03/10万)较2010年(2 171.88/10万)下降了22.60%。 2010和2018年北京市户籍居民脑血管病YLL和DALY的粗率及标化率男性均大于女性,YLD粗率及标化率男性均小于女性。 2018年各年龄组YLL率和DALY率相较于2010年均下降,均为75~79岁年龄组下降幅度最大,分别下降了36.35%和30.37%;YLD率则为55~79岁年龄组下降,15~54岁和≥80岁年龄组上升,其中65~69岁年龄组下降幅度(13.57%)最大,85岁及以上年龄组上升幅度(27.67%)最大。 2010和2018年疾病负担均以缺血性脑卒中为主且占比上升,占脑血管病YLL的比例由59.60%上升至62.21%,占脑血管病YLD的比例由86.99%上升至88.68%,占脑血管病DALY的比例由64.42%上升至72.26%。 疾病负担水平最低的为城区,最高的为远郊。
    结论  2010—2018年北京市户籍居民脑血管病DALY整体下降,其中YLL下降,YLD上升。 北京市脑血管病疾病负担防控的重点人群仍为高年龄组人群和男性人群,其中伤残负担应重点关注女性。 不同亚病种的疾病负担以缺血性脑卒中为主,且北京市疾病负担存在明显地区差异,疾病负担水平最低的为城区,最高的为远郊,但下降幅度最高的均为近郊。

     

    Abstract:
    Objective To compare the disease burden of cerebrovascular disease in local residents in Beijing in 2010 and 2018 and evaluate its variation from 2010 to 2018.
    Methods The years of life lost (YLL) caused by premature death were calculated by using the surveillance data of cerebrovascular disease deaths in local residents in Beijing from 2010 to 2018, and the years lived with disability (YLD) and disability adjusted life years (DALY) were measured by indirect methods.
    Results In 2018, the YLL rate of cerebrovascular disease in local residents in Beijing (2341.69/100 000) decreased by 16.32% compared with 2010 (2798.44/100 000), and the standardized YLL rate (1278.97/1000 000) decreased by 29.00% compared with 2010 (1801.24/100 000). In 2018, the YLD rate (680.27/100 000) increased by 17.10% compared with 2010 (580.95/100 000), and the standardized YLD rate (402.06/100 000) increased by 8.48% compared with 2010 (370.64/100 000). The DALY rate in 2018 (3021.96/100 000) decreased by 10.58% from 2010 (3379.39/100 000), and the standardized DALY rate (1681.03/100 000) decreased by 22.60% from 2010 (2171.88/100 000). The crude and age-standardized YLL and DALY rates were higher in men than in women in both 2010 and 2018, while the crude and age-standardized YLD rates were lower in men than in women. In 2018, the YLL rate and DALY rate in each age group decreased compared with 2010, and decreases in age group 75–79 years were the most obvious, with decreases of 36.35% and 30.37%, and the YLD rate decreased in age group 55–79 years, in which the decrease in age 65–69 years was most obvious (13.57%), but increased in age groups 15–54 years and ≥80 years, in which the increase in 85 years was most obvious (27.67%). In 2010 and 2018, the disease burden was mainly caused by ischemic stroke with an increased proportion, accounting for 59.60%–62.21% in YLL of cerebrovascular disease, the proportion in YLD of cerebrovascular disease increased from 86.99% to 88.68%, and the proportion in DALY of cerebrovascular disease increased from 64.42% to 72.26%. The lowest disease burden level was observed in urban area and the highest in outer suburbs.
    Conclusion From 2010 to 2018, the overall DALY of cerebrovascular disease in local residents in Beijing decreased, in which YLL decreased and YLD increased. The elderly and men are still key groups for the prevention and control of cerebrovascular disease in Beijing. Close attention should be paid to the disability burden in women. Ischemic stroke was the major form of cerebrovascular disease causing disease burden, and there were obvious area specific differences in the disease burden in Beijing, with the lowest disease burden level in urban area and the highest in outer suburbs, but the most obvious decline was observed in suburbs.

     

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