1990—2021年中国缺血性心脏病发病死亡趋势的年龄-时期-队列模型-现代医学

1990—2021年中国缺血性心脏病发病死亡趋势的年龄-时期-队列模型

单位：1. 哈尔滨医科大学附属第二医院普通外科, 黑龙江哈尔滨 150081;
2. 哈尔滨医科大学附属第二医院神经内科, 黑龙江哈尔滨 150081;
3. 齐齐哈尔医学院附属第二医院神经内科, 黑龙江齐齐哈尔 161000;
4. 齐齐哈尔市第一医院, 黑龙江齐齐哈尔 161000

关键词：缺血性心脏病发病率死亡率年龄-时期-队列分析中国

分类号：R541

出版年·卷·期（页码）：2025·53·第一期（10-16）

摘要：

目的: 分析1990—2021年中国缺血性心脏病(IHD)的发病率和死亡率的长期趋势，为中国IHD的防控提供科学建议。方法: 采用全球疾病负担2021(GBD2021)中国IHD的发病和死亡数据，使用Joinpoint模型分析其分段及总体变化趋势，并使用年龄-时期-队列模型评估IHD的年龄、时期和队列效应。结果: 中国IHD的标化发病率和标化死亡率在1990—2021年内总体呈上升趋势。标化发病率的平均年度变化百分比(AAPC)为总人口0.50%、男性0.47%、女性0.48%的速度上升；中国IHD标化死亡率分别以AAPC为总人口0.49%、男性0.95%的速度上升。年龄-时期-队列模型分析结果显示，1990—2021年中国IHD的发病率和死亡率均随年龄的增长呈上升趋势；中国IHD发病率的时期相对危险度(RR)值均呈现先下降后上升,IHD总人口和男性死亡率的时期RR整体呈上升趋势，而女性呈下降趋势；在整个出生队列组间，不同性别人群IHD发病率的队列RR均呈现上升趋势，不同性别人群IHD死亡率的队列RR均呈现先上升后下降的趋势。结论: 中国1990—2021年IHD的发病和死亡负担仍然严峻，应重点加强70岁以上男性的干预。

Objective: To analyze the long-term trend of incidence and mortality of ischemic heart disease(IHD) from 1990 to 2019 in China so as to provide scientific advice on prevention and control of IHD. Methods: The Global Burden of Disease 2021(GBD2021) incidence and mortality data of IHD in China were analyzed and its segmentation and overall trend were studied by using Joinpoint model. The age-period-cohort model was used to evaluate the age, period and cohort effects of IHD. Results: The standardized incidence and mortality of IHD in China showed an increasing trend from 1990 to 2021. The standardized incidence of average annual percent change(AAPC) was 0.50% in the total population, 0.47% in males and 0.48% in females. The IHD standardized mortality rate in China increased by 0.49% AAPC for the total population and 0.95% for males, respectively. The results of APC model analysis showed that the incidence and mortality of IHD in China increased with age from 1990 to 2021. The period relative risk(RR) values of the incidence of IHD in China decreased first and then increased. The period RR values of the total population of IHD and the mortality rate of male showed an overall increasing trend, while the period RR values of female showed a decreasing trend. In the whole birth cohort, the cohort RR of IHD incidence in different gender groups showed an increasing trend, and the cohort RR of IHD mortality in different gender groups showed an increasing trend first and then a decreasing trend. Conclusion: The incidence and death burden of IHD in China from 1990 to 2021 are still serious, and the intervention for males over 70 years old should be strengthened.

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