2006－2020年杭州市居民糖尿病相关疾病死亡趋势分析

张艳; 徐珏; 付文; 刘冰

doi:10.3784/jbjc.202104290452

摘要:

目的了解2006—2020年杭州市居民糖尿病相关疾病死亡率及其变化趋势，为进一步制定糖尿病防控策略提供依据。

方法通过杭州市县级及以上医疗机构和社区卫生服务中心的死亡医学证明书收集2006—2020年杭州市死因监测资料，计算糖尿病相关疾病粗死亡率、标化死亡率，分析糖尿病相关疾病及并发症构成，采用年度变化百分比（APC）分析2006—2020年杭州市居民糖尿病相关疾病死亡率变化趋势。

结果 2006—2020年杭州市居民糖尿病相关疾病粗死亡率为28.48/10万，标化死亡率为18.04/10万，粗死亡率和标化死亡率的APC分别为10.30%和5.97%，均呈逐年上升趋势（P<0.001）。男性粗死亡率为27.71/10万，低于女性的29.25/10万（χ²=21.608，P<0.001），男性和女性标化死亡率的APC分别为7.14%和5.23%，均呈逐年上升趋势（P<0.001）。随着年龄增大，糖尿病相关疾病死亡率逐渐升高（χ²=60 754.086，P<0.001），其中45～54岁、55～64岁和65岁以上组，死亡率均呈逐年上升趋势（P<0.05）。城市标化死亡率为20.66/10万，农村为12.79/10万，APC分别为6.08%和6.61%，均呈逐年上升趋势（P<0.001），且城市高于农村（χ²=24 662.594，P<0.001）。杭州市居民死于糖尿病本身的比例逐年下降，至2020年为28.49%；而死于脑血管病、恶性肿瘤、心脏病、呼吸系统疾病、神经系统疾病、消化系统疾病和泌尿系统疾病的比例则逐年升高。根本死因为糖尿病的病例中不伴有并发症的比例逐年降低，至2020年为11.71%，而伴有昏迷、酮症、肾脏并发症、眼并发症、神经并发症、周围循环并发症以及多个并发症的比例则逐年升高，累计84.92%。

结论 2006—2020年期间杭州市居民糖尿病相关疾病死亡率呈明显上升趋势，根本死因为糖尿病，伴有并发症死亡的比例逐年上升。农村、男性和老年人群应作为糖尿病相关疾病死亡重点关注人群。

Abstract:

Objective To analyze the mortality rate of diabetes melitus (DM) related death and its trend in residents in Hangzhou from 2006 to 2020, and to provide scientific basis for DM prevention and control.

Methods Through the medical certificate of death in hospitals at county level and above and community health service centers,the monitoring data of the death mentioning DM in Hangzhou from 2006 to 2020 were collected. The crude motality rates, standardized mortality rates were calculated. The proportion from DM specified complications were analyzed. The annual percentage change (APC) was used to examine the changing trend of the mortality.

Results The crude mortality rate and the standardized mortality rate of DM related death were 28.48/100 000 and 18.04/100 000 respectively in residents in Hangzhou from 2006 to 2020. The crude and standardized mortality rate from 2006 to 2020 showed increasing trends and the APC were 10.30% and 5.97% (P<0.001). The crude mortality rate was 27.71/100 000 in males,which was lower than 29.25/100 000 in females (χ²=21.608, P<0.001). The standardized mortality rate showed increasing trends in both males and females, the APC were 7.14% and 5.23%, respectively. The crude mortality rate of DM related death in Hangzhou increased gradually with age (χ²=60 754.086, P<0.001). The crude mortality rate in 45–54 years, 55–64 years and over 65 years groups showed upward trends (P<0.05). The standardized mortality rates were 20.66/10 000 in urban areas and 12.79/100 000 in rural areas (χ²=24 662.594, P<0.001), showing increasing trends, the APC were 6.08% and 6.61%, respectively. The proportions of specified complications including ketoacidosis, coma, renal complications, retinopathy, peripheral circulatory and multiple complications increased dramatically which collectively accounted for over 84.92% in the underlying death cause of DM.

Conclusion The mortality of DM related death and proportions of DM complications in residents in Hangzhou increased from 2006 to 2020. More efforts are needed to reduce DM related death in rural residents, males and elderly population.

2006－2020年杭州市居民糖尿病相关疾病死亡趋势分析

Trend of diabetes mellitus related mortality in residents in Hangzhou, 2006−2020