1990—2019年中国缺血性脑卒中发病和死亡趋势及年龄-时期-队列模型分析

王前友; 赵博轩; 王文安

doi:10.16766/j.cnki.issn.1674-4152.003566

1990—2019年中国缺血性脑卒中发病和死亡趋势及年龄-时期-队列模型分析

doi: 10.16766/j.cnki.issn.1674-4152.003566

1.
上海健康医学院附属崇明医院神经内科，上海 202150
2.
上海交通大学医学院附属新华医院神经内科，上海 200092

基金项目:

国家自然科学基金面上项目 81971000

上海市崇明区科学技术发展资金项目 CKY2016-08

详细信息

通讯作者:
王文安，E-mail：13611641232@163.com

中图分类号: R743
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- 被引次数: 0
出版历程
- 收稿日期: 2023-11-29
- 网络出版日期: 2024-07-22

Analysis of trend and age-period-cohort model on ischemic stroke incidence and mortality from 1990 to 2019 in China

1.
Department of Neurology, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai 202150, China

摘要

摘要: 目的分析1990—2019年中国缺血性脑卒中发病、死亡趋势，并探索年龄、时期和队列对缺血性脑卒中发病、死亡风险的影响。方法本研究中中国缺血性脑卒中发病和死因数据来源于全球疾病负担数据库，采用联结点回归模型和年龄-时期-队列(APC)模型分别分析缺血性脑卒中发病率和死亡率的趋势及影响缺血性脑卒中发病和死亡风险的年龄效应、时期效应和队列效应。采用的软件为Jointpoint软件和Stata软件。结果 1990—2019年期间中国缺血性脑卒中的发病率和死亡率均呈现上升趋势，年平均变化百分比分别为3.5%(95% CI：3.5%~3.6%)和2.8%(95% CI：2.5%~3.1%)。APC模型提示缺血性脑卒中的发病和死亡风险均随年龄的增长而增加，随着年份的推移而增加，较晚出生的队列，其发病和死亡风险均低于之前出生的队列。结论 1990—2019年中国缺血性脑卒中总体发病和死亡率呈逐年上升趋势，年龄大、生活时代越近、出生越早的人群缺血性脑卒中发病和死亡风险越高，应重点加强特殊人群的预防，降低该病的疾病负担。
- 缺血性脑卒中 /
- 年龄-时期-队列模型 /
- 趋势分析
Abstract: Objective To analyze the incidence and mortality trend of ischemic stroke in China from 1990 to 2019, and explore the effects of age, period, and cohort on the incidence and mortality risk of ischemic stroke. Methods The incidence and mortality of ischemic stroke in China were collected from the Global Burden of Disease database. The joint regression model and age-period-cohort (APC) model were used to analyze the trend of incidence and mortality of ischemic stroke and the age, period, and cohort effects affecting the incidence and mortality of ischemic stroke, respectively. Jointpoint software and Stata software were used. Results The average annual percent change in incidence and mortality of ischemic stroke in China from 1990 to 2019 was 3.5% (95% CI: 3.5%-3.6%) and 2.8% (95% CI: 2.5%-3.1%), showing an increasing trend. The APC model suggested that the risk of ischemic stroke and death increased with age and year, with the later birth cohort having a lower risk of onset and death than the earlier birth cohort. Conclusion The overall incidence and mortality of ischemic stroke in China increased year by year from 1990 to 2019. The risk of ischemic stroke incidence and death is higher in people with older age, more recent lifetimes, and earlier birth. Prevention of ischemic stroke should be strengthened in special groups to reduce the disease burden.
- Ischemic stroke /
- Age-period-cohort model /
- Trend analysis

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图 1 缺血性脑卒中发病风险的年龄、时期和队列效应

Figure 1. Age, period, and cohort effect for the incidence risk of ischemic stroke

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图 2 缺血性脑卒中死亡风险的年龄、时期和队列效应

Figure 2. Age, period, and cohort effect for the mortality risk of ischemic stroke

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表 1 缺血性脑卒中发病率趋势的联结点回归分析

Table 1. Jointpoint regression analysis of trends in ischemic stroke incidence

变量	年份	APC(95% CI)	AAPC(95% CI)
男性			3.7(3.6~3.7)
	1990—1996	2.2(2.2~2.3)
	1996—2003	2.9(2.8~2.9)
	2003—2006	3.4(3.0~3.7)
	2006—2010	5.0(4.8~5.2)
	2010—2016	5.2(5.1~5.3)
	2016—2019	4.0(3.8~4.2)
女性			3.4(3.3~3.4)
	1990—1995	1.6(1.5~1.8)
	1995—2000	2.9(2.7~3.0)
	2000—2005	2.0(1.9~2.2)
	2005—2010	5.7(5.5~5.8)
	2010—2019	4.1(4.1~4.2)
合计			3.5(3.5~3.6)
	1990—1995	1.9(1.8~2.0)
	1995—2006	2.7(2.7~2.8)
	2006—2009	5.9(5.4~6.4)
	2009—2015	4.7(4.6~4.9)
	2015—2019	4.1(3.9~4.3)

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表 2 缺血性脑卒中死亡率趋势的联结点回归分析

Table 2. Jointpoint regression analysis of trends in ischemic stroke mortality

变量	年份	APC(95% CI)	AAPC(95% CI)
男性	1990—1997	2.3(2.0~2.5)	3.2(3.0~3.4)
	1997—2004	4.8(4.5~5.1)
	2004—2007	0.4(-1.3~2.1)
	2007—2011	5.3(4.4~6.2)
	2011—2019	2.7(2.6~2.9)
女性	1990—1997	1.4(1.0~1.7)	2.5(2.0~2.9)
	1997—2004	5.1(4.6~5.6)
	2004—2007	-1.2(-4.0~1.6)
	2007—2010	3.2(0.3~6.1)
	2010—2015	1.3(0.3~2.2)
	2015—2019	3.6(2.7~4.6)
合计	1990—1997	1.8(1.5~2.1)	2.8(2.5~3.1)
	1997—2004	4.9(4.5~5.3)
	2004—2007	-0.4(-2.5~1.7)
	2007—2010	4.3(2.1~6.5)
	2010—2019	2.6(2.4~2.8)

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