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天津市15年急性心肌梗死发病率变化趋势分析

Fifteen-year trend in incidence of acute myocardial infarction in Tianjin of China

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目的 了解1999至2013年天津市居民急性心肌梗死(AMI)发病率及其变动趋势,探讨其在不同特征人群中的特点,为AMI的预防控制提供依据.方法 采用1999年1月1日至2013月12月31日天津市疾病预防控制中心收集的居民心脑血管疾病新发病例监测数据,统计天津市居民AMI发病率,分析其在不同年龄、性别以及城乡之间分布差异.天津市户籍人口信息来源于天津市公安局.以2000年全国第5次人口普查人口计算年龄别、性别标化发病率.率的比较采用x2检验,发病率的时间趋势和年龄趋势分析采用趋势性x2检验.结果 1999至2013年天津市居民AMI粗发病率为80.46/10万~81.29/10万,标化发病率为64.85/10万~44.57/10万,有逐年下降趋势(Z=-35.767,P<0.001);其中45岁以下人群发病率呈逐年上升趋势(P<0.001),而45岁及以上人群发病率呈逐年下降趋势(P<0.01).男性AMI发病率(粗发病率为99.34/10万~102.98/10万,标化发病率为78.53/10万~56.61/10万)高于女性(粗发病率为61.18/10万~59.44/10万,标化发病率为50.31/10万~31.76/10万;P均<0.001),城市AMI发病率均高于农村(P均<0.001),城市地区下降趋势明显(粗发病率为133.98/10万~98.02/10万,标化发病率为99.89/10万~50.12/10万,Z=-46.968,P< 0.001),农村地区上升趋势明显(粗发病率为35.57/10万~66.19/10万,标化发病率为32.68/10万~43.51/10万;Z=6.217,P<0.001).结论 1999至2013年期间天津市居民AMI发病率总体呈下降趋势,但年轻男性、农村人群为上升趋势,应对不同人群采取有针对的预防干预措施,减少AMI的发生.
Objective To observe the incidence of acute myocardial infavtion (AMI) between 1999 and 2013 in Tianjin residents and analyze the incidence differences on residents with various age,gender and living in urban or rural areas.The data might help for targeted prevention strategies among Tianjin residents.Methods AMI incidence data between 1999 and 2013 were obtained based on Tianjin cardiovascular disease incidence surveillance registry established by the Tianjin Centers for Disease Control and Prevention (CDC).Related information such as permanent residents' population data were obtained from Tianjin Municipal Public Security Bureau.The Chinese population data in 2000 were used for age-sexstandardized rates estimation.Difference between two (or more) independent groups was compared by the Chi Square statistics.The Chi-square test for trend was used for computing the incidence trend in years and ages.Results AMI incidence rate in Tianjin declined from the year 1999 to 2013 with the rude incidence rate of 80.46/100 000 to 81.29/100 000,and with the standardized incidence rate of 64.85/100 000 to 44.57/100 000 (Z =-35.767,P < 0.001).AMI incidence decreased gradually in residents aged over 45 years old (P < 0.01),but increased in residents younger than 45 years old (P < 0.001) from 1999 to 2013.The AMI incidence rate is consistently higher in male residents (rude incidence 99.89/100 000-102.98/100 000,standardized incidence rate 78.53/100 000-56.61/100 000) than in female residents (rude incidence 61.18/100 000-59.44/100 000,standardized incidence rate 50.31/100 000-31.76/100 000,both P < 0.001) and higher in urban residents (rude incidence rate 133.98/100 000-98.02/100 000,standardized incidence rate 99.89/100 000-50.12/100 000) than in rural residents (rude incidence rate 35.57/100 000-66.19/100 000,standardized incidence rate 32.68/100 000-43.51/100 000,Z =6.217,P< 0.001).AMI incidence decreased significantly in the urban residents (rude incidence rate 133.98/100 000-98.02/100 000,standardized incidence rate 99.89/100 000-50.12/100 000,Z=-46.968,P< 0.001),while significantly increased in rural residents (rude incidence rate 35.57/100 000-66.19/100 000,standardized incidence rate 32.68/100 000-43.51/100 000,Z =6.217,P < 0.001) during the study period.Conclusions The general incidence of AMI decreased during the study period in Tianjin residents.However,AMI incidence significantly increased in young male residents and rural residents.It is necessary to develop corresponding strategies for AMI control for Tianjin residents with different age/gender and living in different areas.

Myocardial infarctionIncidencePopulation surveillanceEpidemiology

王德征、沈成凤、张颖、张辉、宋桂德、李威、薛晓丹、徐忠良、张爽

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300011 天津市疾病预防控制中心

心肌梗死 发病率 人群监测 流行病学

天津市卫生局科技基金

2013KY22

2017

中华心血管病杂志
中华医学会

中华心血管病杂志

CSTPCDCSCD北大核心
影响因子:2.846
ISSN:0253-3758
年,卷(期):2017.45(2)
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