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中国和北美地区1990—2017年先天性心脏病死亡率变化趋势比较

Comparison of trends in congenital heart disease mortality from 1990 to 2017 between China and North America

摘要:

目的:分析1990—2017年中国先天性心脏病(先心病)死亡率的变化趋势以及和北美地区的差距。方法:使用2017年全球疾病负担(GBD)研究数据,分析中国和北美地区1990—2017年先心病死亡相关指标,包括标化死亡率、死亡人数、死亡人群年龄分布及每一出生队列的先心病年龄别死亡率;采用年龄-时期-队列(APC)模型,计算先心病标化死亡率及年龄别死亡率的年均变化百分比(%/年)、校正时期因素后的年龄别死亡率及不同时期(以2000—2004年为参考时期)和不同出生队列(以1970年为参考队列)先心病人群的相对死亡风险。结果:2017年,中国和北美地区先心病标化死亡率分别为2.63/10万和1.13/10万,较1990年均明显下降(分别降低50.4%和49.4%);中国5岁以下人群占总死亡人群的76.8%,而在北美地区为51.7%。对于40岁以下人群,中国的校正时期因素后的年龄别死亡率(0.46~167.94/10万人年)整体高于北美地区(0.68~22.47/10万人年);而对于40岁以上人群,中国(0.13~0.34/10万人年)低于北美地区(0.43~0.72/10万人年)。1990至2017年,中国先心病的标化死亡率平均每年下降1.95%;45岁以下人群的死亡率平均每年下降1.95%~3.64%,但50岁以上人群的死亡率每年呈上升趋势。2015—2019年中国先心病的相对死亡风险下降31%,北美地区下降24%。中国2015年出生队列的相对死亡风险下降了84%,北美地区下降了64%。结论:在过去30年间,中国先心病人群的死亡风险降低,和北美地区的差距缩小。然而与北美地区相比,中国低龄患者的死亡率仍然较高,老年人群死亡率呈逐年增加的趋势。

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abstracts:

Objective:To compare trends in congenital heart disease (CHD) mortality between China and North America from 1990 to 2017.Methods:Using the data from the Global Burden Of Disease (GBD) study 2017, we analyzed the related indicators of CHD mortality in China and North America from 1990 to 2017, including standardized mortality, number of deaths, age distribution of death population and age-specific mortality of CHD in each birth cohort. Age-period-cohort model was used to calculate the annual percent change of age-standardized and age-specific mortality rates of CHD (% per year), period effect-adjusted age-specific mortality rates, and the relative risk of death among CHD population at different time periods (2000-2004 as reference period) and different birth cohorts (1970 as reference cohort).Results:In 2017, the age-standardized mortality rates for CHD in China and North America were 2.63/100 000 and 1.13/100 000 respectively, a decrease of 50.4% and 49.4% compared to 1990. Of all deaths from CHD in China, 76.8% were found in children under 5 years, which was higher than that in North America (51.7%). For population under 40 years, the period effect-adjusted age-specific mortality was higher in China (0.46-167.94 per 100 000 person-years) than in North America (0.68-22.47 per 100 000 person-years); whereas for population over 40 years, mortality was lower in China (0.13-0.34/100 000 person years) than in North America (0.43-0.72/100 000 person-years).From 1990 to 2017, CHD mortality in China decreased by 1.95% per year. The annual decrease of mortality ranged from 1.95% to 3.64% per year in population under 45 years, but the mortality showed increasing trends among those over 50 years. In 2015-2019, the relative risk of death from CHD decreased by 31% in China and 24% in North America. For 2015 birth cohort, the relative risk of death decreased by 84% in China and by 64% in North America.Conclusions:In the past 30 years, the risk of death from CHD in China has significantly decreased, and the survival gap with North America is dramatically narrowed. However, mortality is higher among younger populations in China than in North America, and the mortality in the elders shows increasing trends each year in China.

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作者: 苏展豪 李守军 陈会文 张浩
期刊: 《中华心血管病杂志》2021年49卷3期 269-275页 MEDLINEISTICPKUCSCDCABP
栏目名称: 流行学与人群防治
DOI: 10.3760/cma.j.cn112148-20200618-00496
发布时间: 2021-04-06
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