摘要目的:了解1999-2018年天津市居民出血型脑卒中发病特征分析，为制定精准防控策略提供数据支撑。方法:采用1999-2018年天津市出血型脑卒中监测数据，分析出血型脑卒中发病率及其在不同年龄、性别、城乡之间的分布差异。以2010年全国第六次人口普查为标准人口计算标化发病率。率的比较采用 χ 2检验，发病率的时间趋势和年龄趋势分析采用趋势 χ 2检验。采用Joinpoint软件对年发病率的变化进行分析。 结果:研究期间，出血型脑卒中占脑卒中全部病例的13.08%，天津市居民出血型脑卒中粗发病率为75.38/10万~46.70/10万，呈下降趋势（ Z=-28.63， P<0.01，APC=-1.45%）。经过年龄、性别调整后，标化发病率为57.93/10万~27.55/10万，仍呈下降趋势（ Z=-54.72， P<0.01，APC=-3.38%）。男、女性出血型脑卒中粗发病率、标化发病率均呈下降趋势，且在各年份及各年龄组男性发病率均高于女性（ P<0.01），发病年龄呈年轻化，城市、农村出血型脑卒中标化发病率均呈下降趋势（ P<0.01），且城市下降更快。 结论:天津市出血型脑卒中发病特征与发达国家类似，低年龄组、农村人群是干预重点人群，发病特征及趋势研究对于精准防控脑卒中，降低疾病负担和医疗成本具有重要意义。

abstractsObjective:To explore the incidence characteristics of hemorrhagic stroke among residents in Tianjin from 1999 to 2018, to provide data for formulating accurate prevention and control strategies.Methods:The incidence rate of hemorrhagic stroke and its distribution in different ages, gender, urban and rural areas were analyzed by monitoring new hemorrhagic stroke cases in Tianjin from 1999 to 2018. The standardized incidence rate was calculated based on the six th national population census in 2010. χ 2 test was used to compare the incidence rate. The trend of age and trend of age were analyzed by trend χ 2 test. Joinpoint software was used to analyze the change in the annual incidence rate. Results:During the study period, hemorrhagic stroke accounted for 13.08% of all stroke cases. The incidence rate of a hemorrhagic stroke in Tianjin residents was 75.38/100 000-46.70/100 000, showing a downward trend ( Z=-28.63, P<0.01, APC=-1.45%). After adjustment of age and gender, the standardized rate was 57.93/100 000-27.55/100 000, still showing a downward trend ( Z=-54.72, P<0.01, APC=-3.38%). The incidence rate of male and female hemorrhagic stroke decreased, and the incidence rate of males in all ages and age groups was higher than that in females ( P<0.01). The age of onset is younger, and the standardized incidence rate of an urban hemorrhagic stroke in the city decreases ( P<0.01), and the city descends faster. Conclusions:The characteristics of hemorrhagic stroke in Tianjin are similar to those in developed countries. The lower age group and rural population are the key groups of intervention. The study of incidence characteristics and trends is of great significance for accurate prevention and control of stroke, reducing disease and medical costs.