摘要
目的了解重庆市早发急性心肌梗死(AMI)发病率和死亡率及变化趋势,为开展早发AMI防治提供依据。方法早发AMI发病死亡个案来自重庆市心脑血管事件报告系统,采用SPSS 25.0统计发病率、死亡率、标化发病率、标化死亡率、年龄别发病率、年龄别死亡率等指标,不同性别、地区率的比较采用χ^(2)检验。率的趋势分析采用Joinpoint 5.0.2软件,计算平均年度变化百分比(AAPC)。结果重庆市早发AMI发病率与标化发病率由2012年的1.32/10万、1.01/10万上升至2023年的4.48/10万、4.42/10万,AAPC分别为9.64%、10.76%,变化趋势均有统计学意义(P<0.01)。历年男性发病率均高于女性,差异均有统计学意义(P<0.05)。男性早发AMI发病率和标化发病率分别以年均11.84%和13.54%的速度上升,变化趋势均有统计学意义(P<0.01);女性早发AMI发病率和标化发病率变化趋势均无统计学意义(P>0.05)。仅2020和2021年城市早发AMI发病率高于农村,差异均有统计学意义(P<0.05);城市、农村早发AMI的发病率(AAPC分别为10.16%、9.11%)和标化发病率(AAPC分别为10.43%和11.16%)均呈上升趋势,均有统计学意义(P<0.01)。重庆市早发AMI发病率随年龄的增长呈上升趋势;20~29、30~39、40~44岁年龄组早发AMI发病率分别以年均9.38%、13.53%和8.83%的速度上升,变化趋势均有统计学意义(P<0.05)。重庆市早发AMI死亡率与标化死亡率2012年分别为1.52/10万和1.21/10万,2023年分别为1.78/10万和1.76/10万,变化趋势均无统计学意义(P>0.05)。历年男性早发AMI死亡率均高于女性,差异均有统计学意义(P<0.05,P<0.01)。2016年、2017年、2022年和2023年农村早发AMI死亡率均高于城市,差异均有统计学意义(P<0.05,P<0.01)。重庆市早发AMI死亡率随年龄的增长呈上升趋势。20~29岁和30~39岁年龄组早发AMI死亡率分别以年均7.33%和12.84%的速度上升,变化趋势均有统计学意义(P<0.05,P<0.01)。结论重庆市早发AMI发病率较低,呈快速上升趋势,死亡率无明显变化,男性和农村地区是早发AMI防治的重点。
Objective To understand the incidence and mortality of early acute myocardial infarction(AMI)and its trend in Chongqing,and provide the basis for the prevention and control of early AMI.Methods The cases of early AMI were from Chongqing reporting system of cardiovascular and cerebrovascular events.The incidence,age standardized incidence(ASIR),mortality and age standardized mortality rate(ASMR)were calculated.Theχ^(2)test was used to compare the rate of different gender and areas.Joinpoint regression analysis was used to analyze the rate trend,the average annual change percentage(AAPC)was calculated.The used software was SPSS 25.0.Results The incidence and ASIR of early AMI in Chongqing increased from 1.32/105 and 1.01/105 in 2012 to 4.48/105 and 4.42/105 in 2023,AAPC values were 9.64%and 10.76%,respectively;and both changing trends were statistically significant(P<0.01).The incidence in males was significantly higher than that in females in all years(P<0.05).The incidence and ASIR of early AMI in males increased by 11.84%and 13.54%per year,respectively;and both changing trends were statistically significant(P<0.01).But there was no significant change of incidence and ASIR of early AMI in females(P>0.05).Only in 2020 and 2021,the incidence of early AMI in urban areas was significantly higher than that in rural areas(P<0.05).The incidence(AAPC values were 10.16%and 9.11%,respectively)and ASIRs(AAPC values were 10.43%and 11.16%,respectively)of early AMI in urban area and rural area showed upward trend(P<0.01).The incidence of early AMI in Chongqing showed an upward trend with the increase of age.The incidence rates of early AMI in 20-29 years old group,30-39 years old group and 40-44 years old group increased by 9.38%,13.53%and 8.83%per year,respectively;and the changing trends were statistically significant(P<0.05).The mortality and ASMR of early AMI in Chongqing were 1.52/105 and 1.21/105 in 2012,and 1.78/105 and 1.76/105 in 2023,respectively,without significant change trend(P>0.05).The mortality of early AMI in males was significantly higher than that in females in all years(P<0.05 or P<0.01).The mortality of early AMI of rural residents in 2016,2017,2022 and 2023 were significantly higher than those of urban residents(P<0.05 or P<0.01).The mortality of early AMI in Chongqing increased with age.The mortality of early AMI in 20-29 years old group and 30-39 years old group increased by 7.33%and 12.84%per year,respectively(P<0.05,P<0.01).Conclusion The incidence of early AMI in Chongqing is relatively lower but shows a rapid upward trend,and there is no significant change of mortality.Males and rural areas are the key focuses for the prevention and control of early AMI.
作者
丁贤彬
吴荣昆
丁睿
张桂婷
焦艳
高旸
许杰
DING Xianbin;WU Rongkun;DING Rui;ZHANG Guiting;JIAO Yan;GAO Yang;XU Jie(Institute of Chronic Non-communicable Disease Prevention and Control,Chongqing Center for Disease Control and Prevention,Chongqing 400707,China;不详)
出处
《中国慢性病预防与控制》
北大核心
2025年第11期826-830,835,共6页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
重庆市科卫联合医学科研项目(2024ZDXM017,2024MSXM116)。
关键词
早发心肌梗死
发病率
死亡率
趋势分析
Early myocardial infarction
Incidence
Mortality
Trend analysis
