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湖南省2004~2005年居民糖尿病死亡状况及疾病负担研究
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摘要
目的:
     了解湖南省2004-2005年居民糖尿病死亡水平、分布特征及因糖尿病死亡造成的疾病负担,分析可能的原因及危险因素,为制定相应防制策略和措施,预防和控制居民糖尿病的死亡提供科学依据。
     方法:
     1、采用死因回顾性抽样调查的方法,收集湖南省2004-2005年居民死因监测资料;
     2、分别计算糖尿病死亡率、总死因构成等疾病死亡水平指标和早死所致的潜在寿命损失、工作损失、潜在期望寿命损失年和早死生命损失年等疾病负担指标;
     3、采用标准化率的U检验,分析比较居民糖尿病死亡分布及造成的疾病负担差异。
     结果:
     1、2004-2005年湖南省居民糖尿病年均死亡率7.10/10万(标化率4.88/10万),占总死因构成比1.17%(标化构成比1.18%);男性糖尿病粗死亡率为6.06/10万(标化死亡率4.33/10万),女性糖尿病粗死亡率8.22/10万(标化死亡率5.49/10万),女性高于男性(U=2.26,
     P<0.05);城市居民糖尿病粗死亡率为9.94/10万,标化死亡率7.09/10万,农村居民糖尿病粗死亡率为6.15/10万(标化死亡率4.24/10万),城市高于农村(U=29.69,P<0.001);糖尿病死亡率随着年龄增高而呈现上升趋势,主要危及中老年人群,从55岁年龄组死亡率陡增,死亡专率为21.16/10万,80-岁年龄组最高,达到93.98/10万。
     2、糖尿病死亡造成的潜在减寿率(PYLL率)为0.51‰,潜在工作损失率(WPYLL率)为0.35‰。男女性之间、城乡之间PYLL率和WPYLL率无差异。男性APYLL及标化APYLL分别为7.98人年、9.96人年,女性为6.65人年、6.94人年,男性高于女性;农村APYLL(8.41人年)高于城市(5.07人年)。男性AWPYLL及标化AWPYLL分别为5.63人年、7.16人年,女性为4.27人年、4.40人年,男性高于女性;AWPYLL农村(5.85人年)高于城市(3.07人年)。
     3、湖南省居民因糖尿病死亡导致的早死生命损失年率(YLLs/1000)为0.97(标化率0.69),随着年龄的增长而增加,YLLs主要由50岁以上的中老年人承担,占92.25%;YLLs/1000城市高于农村。
     4、湖南省居民因糖尿病死亡所致潜在期望寿命损失年(EPYLLP)为161.78人年,其中城市为141.30人年,农村为168.63人年;农村高于城市,主要危害人群为30-59岁。
     结论:
     1、湖南省居民糖尿病死亡率低于中国中部水平。死亡率、总死因构成比女性高于男性,城市高于农村;随着年龄增长,糖尿病死亡率和构成比增高,55岁以上人群糖尿病死亡率呈加速上升趋势。
     2、湖南省居民糖尿病死亡造成的潜在寿命损失年率和潜在工作损失年率在男女性之间、城乡之间比较接近;平均潜在寿命损失年和潜在工作损失年则为男性高于女性,农村高于城市。
     3、湖南省居民因糖尿病死亡造成的早死生命损失年主要集中在50岁以上的中老年人群,随着年龄的增长而不断增加;早死生命损失年率农村高于城市。
     4、湖南省居民因糖尿病死亡造成的潜在期望寿命损失农村高于城市,主要集中在30-59岁,该年龄段人群应成为防制的重点。
Objective:
     To understand the death levels, the characteristics of distribution, the burden of disease caused by diabetes mellitus death among Hunan residents in 2004-2005, analyze the possible causes, the risk factors, and formulate the strategy for disease control and prevention.
     Methods:
     1 To collect the data of death surveillance in Hunan during 2004-2005 by adopting the death cause of a sample survey methodology.
     2 To calculate mortality rate, proportion of the total death, potential years of life lost (PYLL), working potential years of life lost (WPYLL), the expected years of potential life lost (EYPLL), years of life lost(YLLs) and other related indicators.
     3 Using U-test to analyze and compare with the difference in population distribution of mortality, the burden of disease caused by diabetes mellitus death.
     Results:
     1 The mortality rates of diabetes mellitus were 7.10 per100000 during 2004-2005, which standardized 4.88 per100000, and with the proportion of contribution of 1.17% in death causes of all diseases, which standardized 1.18%. It was higher among females with the mortality rates of 6.06 per100000, which standardized 4.33 per100000 than in males with the mortality rates of 8.22 per100000, which standardized 5.49 per100000 (U=2.26, P< 0.05); it was also higher among urban with the mortality rates of 9.94 per100000, which standardized 7.09 per100000 than in rural with 6.15 per100000, which standardized 4.24 per100000 (U = 29.69, P< 0.001). The mortality rates increased with the age, and the middle and old ages are the main populations. It increased rapidly among people above 55 years, from 21.16 per 100000 in people aged 55 to 93.98 per 100000 in people aged 80, and with the proportion of contribution of 83.14% to people above 55 years.
     2 The rates of potential years of life lost(PYLL) were 0.51‰, and the average of PYLL (APYLL) was 7.24 years; the rates of work potential years of life lost(WPYLL) were 0.35%o and the average of WPYLL (AWPYLL) was 4.87 years. There were no difference in the rates of PYLL and WPYLL on diabetes mellitus dearth among females and males though the APYLL and AWPYLL were lower; and so as among urban and rural.
     3 The rates of years of life lost (YLLs/1000) were 0.97, which standardized 0.69. It was higher in rural than in urban and increased with the age, and the middle and old ages are the main populations with proportion of contribution of 92.25%.
     4 The expected years of potential life lost (EYPLL) was 161.78 years and the main populations was 30-59 years; it was higher in rural with 168.63 years than in urban with 141.30 years.
     Conclusion:
     1 The mortality rates of diabetes mellitus in Hunan Province were lower than in central China. The mortality rates, and the proportion of contribution in the total causes of death were higher in women than in men, so as in urban than in rural areas; the mortality rates of diabetes mellitus were increased with ages, and accelerated in people above the age of 55.
     2 There were no difference on the rates of potential years of life lost and working potential years of life lost in men and women or in urban and rural areas caused by the death of diabetes mellitus in Hunan Province; while the average potential years of life lost and working potential years of life lost were higher.
     3 The years of life lost in residents caused by deaths of diabetes mellitus in Hunan Province increased with age and mainly in the elder above the age group of 50 years.
     4 The expected years of potential life lost caused by diabetes mellitus deaths in Hunan Province was higher in rural areas than in urban, and mainly in group of 30 to 59 years, which should be the focus of prevention and control.
引文
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