首页|2011-2020年广州市肺结核死亡趋势及年龄-时期-队列模型分析

2011-2020年广州市肺结核死亡趋势及年龄-时期-队列模型分析

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目的:分析2011-2020年广州市肺结核患者的死亡情况和死亡率变化趋势,为制定防控策略和措施提供科学依据.方法:采用Joinpoint回归模型分析2011-2020年广州市全年龄段人群肺结核死亡率变化趋势,并计算年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC);使用年龄-时期-队列模型分析广州市20~85岁人群肺结核死亡风险的年龄、时期和队列效应.结果:广州市2011-2020年报告肺结核死亡患者2144例,年均报告标化死亡率为2.57/10万;男性肺结核标化死亡率为4.19/10万,约为女性标化死亡率(0.96/10万)的4.4倍.10年间广州市肺结核年龄标化死亡率总体呈现下降趋势,AAPC为-4.15%(95%CI:-6.41%~-1.85%,P=0.003);其中,女性肺结核死亡率下降速度高于男性,AAPC分别为-6.72%(95%CI:-10.38%~-2.92%,P=0.004)和-3.55%(95%CI:-6.19%~-0.85%,P=0.017).在不同年龄段人群中,0~49岁和≥65岁年龄段人群肺结核死亡率均呈现明显下降趋势,AAPC分别为-7.05%(95%CI:-11.52%~-2.34%,P=0.009)和-3.94%(95%CI:-6.22%~-1.62%,P=0.005).年龄-时期-队列模型的年龄效应显示,随着年龄的增长,肺结核死亡风险不断上升,≥65岁人群尤为显著,发病率由66~67岁年龄组的2.93/10万增长至84~85岁年龄组的6.10/10万.时期效应显示,肺结核死亡风险随着时期的变化总体呈现下降趋势,相对危险度(risk ratio,RR)从2011-2012年时期组的1.35下降至2019-2020年时期组的0.81.队列效应显示,越晚出生的人群肺结核死亡风险越低,RR值从1926-1927年出生队列的5.91降低至1998-1999年出生队列的0.16.结论:广州市肺结核死亡率总体呈不断下降的趋势,但男性和女性肺结核死亡率差距较大.需重点关注男性和≥65岁年龄段的老年人群,并实施针对性的防控和治疗措施.
Analysis of mortality trend of pulmonary tuberculosis cases with an age-period-cohort model in Guangzhou City,2011-2020
Objective:Analyze pulmonary tuberculosis caused mortality rate and its changing trend in Guangzhou City from 2011 to 2020,in order to provide a scientific basis for formulating prevention and control strategies and measures.Methods:The Joinpoint regression model was used to analyze the change trend of tuberculosis mortality rates in all age groups in Guangzhou from 2011 to 2020.Annual percent change(APC)and average annual percent change(AAPC)were calculated.Age-period-cohort model was used to analyze the age,period and cohort effects on risk of pulmonary tuberculosis caused death in 20-85 years old populations in Guangzhou.Results:From 2011 to 2020,2144 cases died of pulmonary tuberculosis were reported in Guangzhou,with an average annual standardized mortality rate of 2.57/100 000.The standardized mortality rate of male was 4.19/100 000,about 4.4 times of that of females(0.96/100 000).The age-standardized mortality rates showed a decreasing trend in the past 10 years,AAPC was-4.15%(95%CI:-6.41%--1.85%,P=0.003).The mortality rates decreased faster in females(AAPC=-6.72%,95%CI:-10.38%--2.92%,P=0.004)than in males(-3.55%,95%CI:-6.19%--0.85%,P=0.017).For different age groups,the mortality rates of pulmonary tuberculosis in 0-49 years old group and ≥65 years old group showed significant downward trends,their AAPC were-7.05%(95%CI:-11.52%--2.34%,P=0.009)and-3.94%(95%CI:-6.22%--1.62%,P=0.005)respectively.The age-period-cohort model showed that risk of tuberculosis death increased with age,particularly in people over 65 years old,from 2.93/100 000 in the 66-67 age group to 6.10/100 000 in the 84-85 age group.The period effect showed that the overall risk of tuberculosis death showed a downward trend with the change of period,risk ratio(RR)decreased from 1.35 in the 2011-2012 period group to 0.81 in the 2019-2020 period group.The cohort effect showed a lower risk of tuberculosis death for those born later,with RR decreasing from 5.91 in the 1926-1927 born cohort to 0.16 in the 1998-1999 born cohort.Conclusion:The mortality rate of pulmonary tuberculosis in Guangzhou showed a decreasing trend,but there was a large gap between male and female.It is necessary to focus on men and elderly people over 65 years old and implement targeted prevention and treatment measures.

Tuberculosis,pulmonaryMortalityRegression analysisCohort studies

李雪秋、刘群、唐科、吴迪

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广州市胸科医院结核病防治所一分所,广州 510095

广东省生物制品与药物研究所药理研究室,广州 510440

广州市疾病预防控制中心慢性非传染性疾病预防控制部,广州 510440

广东医科大学公共卫生学院,东莞 523808

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结核,肺 死亡率 回归分析 队列研究

2025

中国防痨杂志
中国防痨协会

中国防痨杂志

北大核心
影响因子:2.527
ISSN:1000-6621
年,卷(期):2025.47(1)