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

张艳, 徐珏, 付文, 刘冰. 2006-2020年杭州市居民糖尿病相关疾病死亡趋势分析[J]. 疾病监测.
引用本文: 张艳, 徐珏, 付文, 刘冰. 2006-2020年杭州市居民糖尿病相关疾病死亡趋势分析[J]. 疾病监测.
Zhang Yan, Xu Jue, Fu Wen, Liu Bing. Trend of diabetes mellitus related mortality in residents in Hangzhou, 2006−2020[J]. Disease Surveillance.
Citation: Zhang Yan, Xu Jue, Fu Wen, Liu Bing. Trend of diabetes mellitus related mortality in residents in Hangzhou, 2006−2020[J]. Disease Surveillance.

2006-2020年杭州市居民糖尿病相关疾病死亡趋势分析

详细信息
    作者简介:

    张艳,浙江省东阳市人,硕士,主管医师,从事慢性非传染性疾病防治工作

    通讯作者:

    张艳,Tel:0571–86905271,Email:465798281@qq.com

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

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  • 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。
  • 表  1  2006-2020年杭州市不同性别居民糖尿病相关疾病死亡率

    Table  1.   Gender specific mortality rate of diabetes melitus related death in residents in Hangzhou, 2006−2020

    年份男性女性合计
    死亡数
    (例)
    粗死亡率
    (/10万)
    标化死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    标化死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    标化死亡率
    (/10万)
    200640812.7311.1045414.4611.0386213.5811.97
    200747314.6611.7757518.0814.76104816.3613.23
    200855116.4014.8964119.5418.86119217.9516.83
    200946914.209.8765220.0414.72112117.1012.23
    201050715.2411.0366720.2814.97117417.7412.93
    201153616.0210.4665419.6413.45119017.8211.90
    201261318.1712.2368820.3914.39130119.2813.29
    201363418.6412.1278523.0015.69141920.8313.85
    201476522.2614.1882423.8315.88158923.0515.00
    201592826.7114.90104229.7117.59197028.2216.18
    2016122034.7019.06133937.6721.86255936.1920.41
    2017151842.0122.30144739.5622.51296540.7822.43
    2018181249.3526.10168445.1425.17349647.2325.68
    2019193351.2626.59177046.1524.86370348.6825.74
    2020201352.0725.72197450.0626.54398751.0626.13
    β0.1110.0690.0860.0510.0980.058
    APC11.747.148.985.2310.305.97
    t11.6726.22312.4746.07512.5746.258
    P<0.001<0.001<0.001<0.001<0.001<0.001
    注:APC. 年度变化百分比;−. 无数据
    下载: 导出CSV

    表  2  2006-2020年杭州市不同年龄组居民糖尿病相关疾病死亡率

    Table  2.   Age specific mortality rate of diabetes melitus related death in residents in Hangzhou, 2006−2020

    年份0~岁35~岁45~岁55~岁65~岁
    死亡数
    (例)
    粗死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    200640.14161.30494.8712121.3267298.39
    200770.25161.29424.0110116.14882123.96
    200840.1470.57484.3912418.491009138.71
    200920.08171.44413.5010212.89959125.47
    201010.04171.46474.0514418.47965126.57
    201130.12151.34483.9211913.081005122.13
    201230.1180.70484.0912614.651116137.84
    201360.22110.97605.1013615.191206143.33
    201480.29131.16564.6615917.431353154.52
    201570.2660.58594.6216916.311729175.13
    201680.30100.98917.0023822.772212215.46
    201740.14161.53755.7525924.272611242.61
    201860.21201.86766.0432729.103067271.79
    201950.17222.00857.0030426.003287273.64
    202060.20191.68847.0828824.153590280.27
    β0.0500.0290.0420.0350.073
    APC5.132.944.293.567.57
    t1.5391.2774.8932.77810.634
    P0.1480.224<0.0010.016<0.001
    注:APC. 年度变化百分比;−. 无数据
    下载: 导出CSV

    表  3  2006-2020年杭州市城乡居民糖尿病相关疾病死亡率

    Table  3.   Mortality rates of diabetes melitus related death in urban and rural residents in Hangzhou, 2006−2020

    年份城市农村
    死亡数
    (例)
    粗死亡率
    (/10万)
    标化死亡率
    (/10万)
    死亡数
    (例)
    粗死亡率
    (/10万)
    标化死亡率
    (/10万)
    200668717.5814.561757.187.03
    200780420.7015.952449.688.45
    200890922.1017.2628311.209.32
    200980019.8813.3732112.6810.01
    201086021.0813.4731412.389.53
    201185420.6612.8633613.219.97
    201290021.4214.2340115.7411.53
    2013103124.1815.6738815.2110.62
    2014115826.7317.0243116.8211.43
    2015151934.4518.4245117.5311.54
    2016198444.1823.3657522.2914.44
    2017233349.8626.2063224.3814.85
    2018272556.8029.7377129.6117.65
    2019286057.2729.4484332.2718.32
    2020307259.1629.8491534.9718.68
    β0.0940.0590.1000.064
    APC9.866.0810.526.61
    t9.8185.78618.53613.907
    P<0.001<0.001<0.001<0.001
    注:APC. 年度变化百分比;−. 无数据
    下载: 导出CSV

    表  4  2006-2020年杭州市居民糖尿病相关疾病死亡疾病分类及构成情况

    Table  4.   Proportion of diabetes melitus related death in residents in Hangzhou, 2006−2020

    年份合计糖尿病相关疾病(%)
    糖尿病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泌尿系统疾病其他
    2006 86274.599.635.925.681.620.120.350.002.09
    2007104866.418.878.788.211.530.101.430.484.20
    2008119270.647.978.987.211.260.250.840.172.68
    2009112176.987.945.174.731.690.270.360.182.68
    2010117470.9510.906.306.641.960.090.600.262.30
    2011119065.7111.347.657.982.020.500.670.423.70
    2012130158.7213.768.929.154.000.310.380.694.07
    2013141958.9913.609.738.882.960.921.060.073.81
    2014158950.4717.0511.149.943.961.511.070.254.59
    2015197044.8216.3514.4710.106.550.761.470.964.52
    2016255935.4419.8116.6114.264.571.171.720.865.55
    2017296530.1220.5717.4714.506.341.691.750.786.78
    2018349628.3819.7118.9914.736.241.951.830.727.47
    2019370329.0020.6718.9815.585.831.351.890.817.48
    2020398728.4920.6717.5115.955.191.962.460.707.07
    总计2957643.7816.6514.1912.084.541.171.490.605.50
    下载: 导出CSV

    表  5  2006-2020年杭州市居民根本死因为糖尿病的并发症构成情况

    Table  5.   Proportion of diabetes melitus specified complications in residents with diabetes as underlying cause of death in Hangzhou, 2006−2020

    年份死亡数(例)并发症分类(%)
    不伴有昏迷酮症肾并发症眼并发症神经并发症周围循环多个并发症其他及未特指的
    200664338.416.8419.6015.711.090.312.644.3511.04
    200769622.135.3217.8224.571.440.144.453.1620.98
    200884220.436.2917.5830.400.710.484.992.7316.39
    200986315.875.3316.4535.341.041.743.245.2115.76
    201083316.696.2415.2535.290.480.365.286.6013.81
    201178210.366.3915.3538.490.510.774.229.9713.94
    201276410.473.6613.6139.010.390.265.2411.6515.71
    201383712.073.4613.2633.690.960.726.6911.9517.20
    201480213.092.7415.2128.930.872.006.2314.7116.21
    201588311.213.6211.4430.461.131.135.4417.8917.67
    20169078.603.4210.3634.070.550.669.0414.8818.41
    201789311.202.697.7332.591.341.468.4014.7819.82
    201899216.033.734.4433.170.711.019.1715.6316.13
    2019107415.552.424.1932.310.651.588.3813.6921.23
    2020113611.713.434.1435.300.791.946.3414.0022.36
    合计1294715.084.2511.7732.330.831.036.1711.1517.39
    下载: 导出CSV
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    [24] Saydah SH, Geiss LS, Tierney E, et al. Review of the performance of methods to identify diabetes cases among vital statistics, administrative, and survey data[J]. Annals of epidemiology, 2004, 14(7): 507–516. DOI:  10.1016/j.annepidem.2003.09.016.
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  • 收稿日期:  2022-04-29
  • 网络出版日期:  2022-07-01

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