首页|2015~2019年中国居民急性心肌梗死发病和死亡特征分析

2015~2019年中国居民急性心肌梗死发病和死亡特征分析

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目的:分析 2015~2019 年中国居民急性心肌梗死(AMI)发病、死亡特征及其变化情况.方法:利用覆盖全国 31 个省级行政区 100 个县(市、区)的"中国居民心脑血管事件登记系统"数据,纳入2015~2019 年报告的AMI发病和死亡病例,以监测地区常住人口为分母,计算年度AMI粗发病率;以第七次全国人口普查数据为标准人口,采用直接标化法计算年龄标化发病率;运用Joinpoint模型分析AMI发病率的年度变化百分比(APC)及变化趋势;以年度AMI个案的死亡数量(例)与报告发病数量(例)的比值计算死亡发病比.结果:2015~2019 年,监测地区共累计报告AMI发病病例 257 686 例,死亡病例 149 169 例.2019 年AMI粗发病率为 82.76/10 万,男性AMI粗发病率高于女性,农村高于城市.2015~2019 年AMI粗发病率趋于平稳(P>0.05),男性AMI粗发病率升高 6.05%(APC=1.30%,95%CI:0.56%~2.02%),女性下降 11.80%(APC=-3.10%,95%CI:-4.54%~-1.68%).2019 年AMI年龄标化发病率为 94.82/10 万,比 2015 年下降 16.59%(APC=-4.32%,95%CI:-5.32%~-3.34%),男性和女性AMI年龄标化发病率分别降低 12.57%(APC=-2.72%,95%CI:-3.78%~-1.67%)和23.96%(APC=-6.56%,95%CI:-8.57%~-4.58%),城市和农村分别降低 14.37%(APC=-3.08%,95%CI:-6.01%~-0.08%)和 19.24%(APC=-5.18%,95%CI:-10.19%~0.03%).AMI发病率随年龄增长而升高.相比 2015 年,2019 年城市 35~44 岁男性和 45~54 岁男性AMI发病率分别升高 77.16%(APC=13.52%,95%CI:3.29%~24.57%))和 26.36%(APC=5.71%,95%CI:-0.95%~12.68%),而≥65 岁总人群的AMI发病率则趋于下降,65~74 岁降低 26.58%(APC=-6.68%,95%CI:-11.98%~-1.01%),75~84 岁降低 19.85%(APC=-5.64%,95%CI:-11.57%~0.65%),≥85 岁降低14.53%(APC=-4.44%,95%CI:-7.75%~-1.04%).2015~2019年总体AMI死亡发病比为0.58,女性死亡发病比高于男性,农村高于城市.相比 2015 年,2019 年AMI总体死亡发病比降低 16.12%(APC=-4.28%,95%CI:-5.75%~-2.83%),其中城市男性、城市女性、农村男性AMI死亡发病比趋于下降(P均<0.05),而农村女性维持稳定(P>0.05).结论:2015~2019 年间监测地区AMI发病率总体平稳,老年人和女性AMI发病率下降,城市中年男性AMI发病率升高.AMI死亡存在城乡、年龄和性别的差异化分布,需要进一步提升AMI救治水平.
Incidence and Mortality Feature of Acute Myocardial Infarction From 2015 to 2019 in China
Objectives:The present study aims to investigate the incidence and mortality feature of acute myocardial infarction(AMI)from 2015 to 2019 in China by utilizing national registry data.Methods:Data of AMI incidence and mortality in the surveillance area during 2015 to 2019 were abstracted from China Registry of Acute Cardiovascular Event(China RACE),which was established in 100 counties from 31 provincial regions in China.Incidence rate,age standardized incidence rate(ASIR)and mortality to incidence ratio(M/I)was estimated in AMI cases.A Joinpoint regression was executed and annual percent change(APC)was examined to identify trends in incidence.Results:From 2015 to 2019,a total of 257 686 acute myocardial infarction incidence and 149 169 deaths were registered.The annual incidence rate of AMI in 2019 was 82.76 per 100 000.Over the study period,the incidence rate of AMI increased by 6.05%for men(APC=1.30%,95%CI:0.56%to 2.02%)but decreased by 11.80%for women(APC=-3.10%,95%CI:-4.54%to-1.68%),resulting a steady trend for AMI crude incidence rate for the overall population.The overall ASIR of AMI declined by 16.59%(APC=-4.32%,95%CI:-5.32%to-3.34%)from 113.68 per 100 000 in 2015 to 94.82 per 100 000 in 2019.The ASIR of AMI declined by 11.04%(APC=-2.72%,95%CI:-3.78%to-1.67%)for men,23.96%(APC=-6.56%,95%CI:-8.57%to-4.58%)for women,12.57%(APC=-3.08%,95%CI:-6.01%to-0.08%)for the urban areas,and 19.24%(APC=-5.18%,95%CI:-10.19%to 0.03%)for rural areas respectively.The incidence rate of AMI increases gradually with age in both men and women.The incidence of AMI in urban men of 35-44 and 45-54 year age groups increased by 77.16%(APC=13.52%,95%CI:3.29%to 24.57%)and 26.36%(APC=5.71%,95%CI:-0.95%to 12.68%)over time.However,the incidence of AMI fell in the population above 65 year old,by 26.58%(APC=-6.68%,95%CI:-11.98%to-1.01%),19.85%(APC=-5.64%,95%CI:-11.57%to 0.65%)and 14.53%(APC=-4.44%,95%CI:-7.75%to-1.04%)in the 65-74 year age,75-84 year age and≥85year age groups respectively from 2015 to 2019.The mortality to incidence ratio of AMI was 0.58 over time,higher in women than in men,and higher in rural areas than in urban areas.The M/I ratio of AMI decreased from 0.62 in 2015 to 0.52 in 2019(APC=-4.28%,95%CI:-5.75%to-2.83%).There was a declined trends in M/I of AMI in urban residents of both male and female,and in the rural male residents(all P<0.05),while a steady trend in the rural female residents(P>0.05).Conclusions:The overall incidence of AMI remains steady during 2015 to 2019 in the national surveillance areas in China.Yet,downward trends in elder and female residents and increased trend in middle-aged urban males in AMI incidence are observed.The mortality of AMI in these period are age,sex and urban-rural dependent.Targeted mitigation strategies on AMI prevention and treatment need to be strengthened to reduce its incidence and mortality.

acute myocardial infarctionincidencemortality to incidence ratioregistry

颜流霞、厚磊、蔡小宁、龙政、陈晓荣、吴静

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中国疾病预防控制中心 慢性非传染性疾病预防控制中心,北京 100050

首都医科大学宣武医院 医务处,北京 100053

急性心肌梗死 发病率 死亡发病比 登记

中央补助地方公共卫生专项慢性病综合干预"中国居民心脑血管事件报告试点项目(2014-2020)

2024

中国循环杂志
中国医学科学院

中国循环杂志

CSTPCD北大核心
影响因子:2.803
ISSN:1000-3614
年,卷(期):2024.39(10)