中国0~14岁儿童2012—2021年慢性病死亡流行特征分析

汤鑫; 朱焱; 张悦羚; 聂颖; 方雪

doi:10.16835/j.cnki.1000-9817.2023.12.024

中国0~14岁儿童2012—2021年慢性病死亡流行特征分析

doi: 10.16835/j.cnki.1000-9817.2023.12.024

汤鑫¹,
朱焱^1, ,,
张悦羚²,
聂颖¹,
方雪¹

1.
贵州医科大学公共卫生与健康学院，贵阳 561113
2.
北京外国语大学国际商学院

基金项目:

贵州省卫生健康委科学技术基金项目 gzwkj2021-405

贵阳市社科基金项目 [2021]102号

详细信息

作者简介:
汤鑫(1997-)，男，贵州省人，在读硕士，主要研究方向为儿童青少年健康发展

通讯作者:
朱焱，E-mail：584684662@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R181.3⁺² R179 R821.3⁺⁶
计量
- 文章访问数: 537
- HTML全文浏览量: 206
- PDF下载量: 64
- 被引次数: 0
出版历程
- 收稿日期: 2023-08-23
- 修回日期: 2023-10-24
- 网络出版日期: 2023-12-26
- 刊出日期: 2023-12-25

Epidemiological characteristics of chronic diseases mortality among children aged 0-14 in China during 2012-2021

1.
School of Public Health, Guizhou Medical University, Guiyang (561113), Guizhou Province, China

摘要

摘要: 目的了解中国2012—2021年0~14岁儿童慢性病死亡的流行特征及趋势，为制定儿童慢性病预防策略提供科学依据。方法对《中国死因监测数据集》中的2012—2021年0~14岁儿童慢性病死亡资料进行描述流行病学分析，并采用Joinpoint回归模型分析儿童慢性病死亡率的平均年度变化百分比(AAPC)。结果 2012—2021年中国0~14岁儿童慢性病死亡率(23.33/10万，19.54/10万，19.27/10万，17.69/10万，16.87/10万，16.44/10万，14.49/10万，13.79/10万，11.61/10万，9.43/10万)总体呈下降趋势(AAPC=-7.94%，P＜0.01)。男童、女童、城市儿童、乡村儿童慢性病死亡率总体均呈下降趋势(AAPC分别为-8.44%，-7.05%，-8.42%，-6.77%，P值均＜0.05)。男童慢性病年均死亡率(16.81/10万)高于女童(13.96/10万)(χ²=526.44，P＜0.01)；中部地区城市儿童慢性病年均死亡率(15.98/10万)高于乡村(13.46/10万)，西部地区乡村(19.75/10万)高于城市(15.96/10万)(χ²值分别为117.63，190.25，P值均＜0.01)。除恶性肿瘤外，儿童先天异常、神经系统和精神障碍疾病、心血管疾病、消化系统疾病总体死亡率均呈下降趋势(AAPC分别为-11.48%，-2.92%，-7.82%，-12.51%，P值均＜0.05)。结论中国儿童慢性病死亡率2012—2021年总体呈下降趋势，但慢性病防控形势依然严峻。应采取针对性的预防策略，重点关注男童和5岁以下儿童的预防保健工作。
- 慢性病 /
- 死亡率 /
- 流行病学研究 /
- 回归分析 /
- 儿童
Abstract: Objective To analyze the epidemiological characteristics and trends of chronic disease mortality among children aged 0-14 in China during 2012-2021, so as to provide scientific basis for the formulation of prevention strategies for chronic diseases in children. Methods The descriptive epidemiological analysis was conducted for chronic disease mortality among children aged 0-14 during 2012 to 2021 from China Cause of Death Surveillance Data Set, and the Joinpoint regression models were used to analyze the average annual percentage change (AAPC) of child chronic disease mortality. Results From 2012 to 2021, the mortality rates of chronic diseases among children aged 0-14 years in China (23.33/100 000, 19.54/100 000, 19.27/100 000, 17.69/100 000, 16.87/100 000, 16.44/100 000, 14.49/100 000, 13.79/100 000, 11.61/100 000, 9.43/100 000)showed a decreasing trend (AAPC=-7.94%, P < 0.01). The overall mortality rates for boys and girls and for chronic diseases were decreasing in both urban and rural areas (AAPC=-8.44%, -7.05%, -8.42%, -6.77%, P < 0.05). The average annual mortality rate of chronic diseases was higher in boys (16.81/100 000) than in girls (13.96/100 000) (χ²=526.44, P < 0.01). The average annual mortality rate from chronic diseases among children was higher in urban (15.98/100 000) than in rural areas (13.46/100 000) in the central region, and higher in rural (19.75/100 000) than in urban areas (15.96/100 000) in the western region (χ²=117.63, 190.25, P < 0.01). Except for malignant tumors, the trend of overall mortality rates of congenital abnormalities, neurological and mental disorders, cardiovascular diseases, and digestive system diseases were all decreasing (AAPC=-11.48%, -2.92%, -7.82%, -12.51%, P < 0.05). Conclusions The overall mortality rate of chronic diseases in children in China shows a downward trend during 2012-2021, but the situation of chronic disease prevention and control is still severe. Targeted prevention strategies should be adopted, focusing on the prevention and health care of males, children under 5 years old.
- Chronic disease /
- Mortality /
- Epidemiologic studies /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 中国2012—2021年不同性别、地区和年龄儿童慢性病死亡率及变化趋势

Table 1. Mortality rates and trends from chronic diseases by sex, region and age for children in China, 2012-2021

年份	性别/10^-5		城乡/10^-5		年龄/10^-5				慢性病死亡占全死因比例/%
年份	男	女	城市	乡村	0~＜1岁	1~＜5岁	5~＜10岁	10~14岁	慢性病死亡占全死因比例/%
2012	24.92	21.48	20.35	24.66	185.60	18.78	8.67	9.71	30.88
2013	21.43	17.33	20.11	19.34	150.54	16.27	7.24	9.16	31.36
2014	21.23	17.00	20.69	18.78	138.10	16.44	7.56	9.29	32.02
2015	19.20	15.96	18.93	17.25	120.85	15.43	7.23	9.21	33.05
2016	18.49	15.00	17.78	16.54	109.25	14.24	7.42	9.31	32.67
2017	18.14	14.47	16.66	16.36	104.49	13.34	7.51	9.64	35.34
2018	15.84	12.92	14.44	14.51	84.56	11.96	7.08	9.46	35.74
2019	15.09	12.31	13.38	13.96	75.77	11.17	7.88	9.14	36.92
2020	12.12	11.03	11.32	11.74	61.03	8.85	7.40	8.64	36.46
2021	9.67	9.15	8.42	9.87	54.28	8.50	5.91	7.55	36.42
AAPC值/%	-8.44	-7.05	-8.42	-6.77	-11.79	-8.17	-1.51	-2.18	2.86
P值	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	0.15	＜0.01	＜0.01

下载: 导出CSV

表 2 中国2012—2021年不同性别、地区和年龄儿童主要慢性病死因构成/%

Table 2. Composition of leading causes of death from chronic diseases among children in different sex, region and age in China, 2012-2021/%

组别	选项	死亡人数	恶性肿瘤	其他肿瘤	糖尿病	内分泌紊乱	神经系统和精神障碍疾病	心血管疾病	呼吸系统疾病	消化系统疾病	泌尿系统疾病	先天异常
性别	男	36 429	22.14	1.08	0.22	4.75	13.43	6.55	2.78	5.47	1.32	42.26
	女	26 108	22.27	1.16	0.33	4.56	11.57	6.79	2.58	5.04	1.41	44.27
城乡	城市	17 415	21.94	1.21	0.25	4.80	12.97	6.87	2.40	3.96	1.15	44.46
	乡村	45 122	22.29	1.07	0.27	4.63	12.54	6.57	2.81	5.81	1.44	42.57
年龄/岁	0~＜1	26 559	4.42	0.52	0.05	4.00	5.17	4.23	2.65	7.10	0.44	71.43
	1~＜5	14 582	28.28	1.59	0.16	5.95	15.63	5.87	3.13	6.21	1.17	32.01
	5~＜10	10 364	40.35	1.76	0.47	5.03	20.56	8.32	2.42	2.57	2.16	16.36
	10~14	11 032	39.92	1.29	0.73	4.27	19.62	11.97	2.49	2.24	3.07	14.70
合计		62 537	22.20	1.11	0.26	4.67	12.66	6.65	2.68	5.29	1.36	43.11

下载: 导出CSV

表 3 中国2012—2021年不同性别、地区和年龄儿童主要慢性病死因率/10^-5

Table 3. Distribution of cause of death rates from chronic diseases among children in different sex, region and age in China, 2012-2021/10^-5

组别	选项	恶性肿瘤	其他肿瘤	糖尿病	内分泌紊乱	神经系统和精神障碍疾病	心血管疾病	呼吸系统疾病	消化系统疾病	泌尿系统疾病	先天异常	合计
性别	男	3.72	0.18	0.04	0.80	2.26	1.10	0.47	0.92	0.22	7.11	16.81
	女	3.11	0.16	0.05	0.64	1.62	0.95	0.36	0.70	0.20	6.18	13.96
城乡	城市	3.39	0.19	0.04	0.74	2.00	1.06	0.37	0.61	0.18	6.86	15.44
	乡村	3.46	0.17	0.04	0.72	1.95	1.02	0.44	0.90	0.22	6.61	15.52
年龄/岁	0~＜1	4.50	0.53	0.05	4.08	5.26	4.31	2.71	7.23	0.45	72.79	101.92
	1~＜5	3.66	0.21	0.02	0.77	2.02	0.76	0.41	0.80	0.15	4.15	12.95
	5~＜10	2.93	0.13	0.03	0.37	1.50	0.60	0.18	0.19	0.16	1.19	7.27
	10~14	3.59	0.12	0.07	0.38	1.77	1.08	0.22	0.20	0.28	1.32	9.01
合计		3.44	0.17	0.04	0.72	1.96	1.03	0.42	0.82	0.21	6.68	15.49

下载: 导出CSV

表 4 中国2012—2021年0~14岁儿童前5位主要慢性病死因的死亡率及变化趋势/10^-5

Table 4. Mortality rates and trends in the top 5 chronic diseases among children aged 0-14 years in China, 2012-2021/10^-5

年份	先天异常	神经系统和精神障碍疾病	心血管疾病	消化系统疾病	恶性肿瘤
2012	11.93	2.02	1.21	1.96	3.84
2013	9.60	2.04	1.34	1.17	3.30
2014	9.49	2.19	1.02	1.05	3.64
2015	7.98	2.00	1.01	1.09	3.87
2016	7.57	2.02	0.96	0.92	3.74
2017	7.18	1.99	1.09	0.80	3.80
2018	5.92	2.06	0.96	0.69	3.40
2019	5.25	2.06	0.97	0.60	3.47
2020	4.11	1.79	0.92	0.47	3.12
2021	2.84	1.55	1.02	0.43	2.61
AAPC值/%	-11.48	-2.92	-7.82	-12.51	-2.59
P值	＜0.01	＜0.05	＜0.01	＜0.01	0.14

下载: 导出CSV

表 5 2012—2021年中国东中西部地区城乡0~14岁儿童慢性病死亡情况/10^-5

Table 5. Deaths of among children aged 0-14 years from urban and rural chronic diseases in eastern, central and western regions in China from 2012 to 2021/10^-5

年份	东部			中部			西部
年份	城市	乡村	合计	城市	乡村	合计	城市	乡村	合计
2012	19.55	22.87	21.53	20.17	20.37	20.31	22.28	31.14	29.06
2013	22.75	17.67	19.06	18.35	16.62	16.99	18.68	25.48	23.61
2014	19.50	17.02	17.73	22.07	17.60	18.50	20.93	22.99	22.35
2015	17.08	16.39	16.58	21.24	15.21	16.46	18.98	21.36	20.59
2016	16.52	15.15	15.55	19.95	14.68	15.88	16.95	21.42	19.45
2017	15.39	16.53	16.19	17.45	13.91	14.70	17.49	19.75	19.03
2018	13.89	13.81	13.83	14.65	13.00	13.39	14.94	17.66	16.81
2019	11.87	12.96	12.58	13.78	12.50	12.81	14.80	17.74	16.57
2020	10.41	10.99	10.79	11.26	9.97	10.29	12.24	15.27	14.30
2021	6.86	8.03	7.67	8.35	6.38	8.64	10.34	13.92	12.66
总计	14.55	14.34	14.40	15.98	13.46	14.24	15.96	19.75	18.46

下载: 导出CSV

参考文献(19)

[1]	陶芳标. 儿童少年卫生学[M]. 8版. 北京: 人民卫生出版社, 2017. TAO F B. Child and adolescent health[M]. 8th ed. Beijing: People's Medical Publishing House, 2017. (in Chinese)
[2]	胡世莲, 王静, 程翠, 等. 中国居民慢性病的流行病学趋势分析[J]. 中国临床保健杂志, 2020, 23(3): 289-294. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202003004.htm HU S L, WANG J, CHENG C, et al. Epidemiological analysis of chronic diseases in Chinese residents[J]. Chin J Clin Health Care, 2020, 23(3): 289-294. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202003004.htm
[3]	李双子, 张萍, 罗业涛, 等. 慢性病患儿及家庭延续护理需求现状及分析[J]. 解放军护理杂志, 2018, 35(24): 46-50. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201824014.htm LI S Z, ZHANG P, LUO Y T, et al. Demands of transitional care for children with chronic diseases and their families[J]. J Chin Nurs PLA, 2018, 35(24): 46-50. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201824014.htm
[4]	ROTH A G, ABATE D, ABATE H K, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018, 392(10159): 1736-1788. doi: 10.1016/S0140-6736(18)32203-7
[5]	中国疾病预防控制中心慢性非传染性疾病预防控制中心, 中华人民共和国国家卫生健康委统计信息中心. 中国死因监测数据集[EB/OL]. (2023-12-07)[2023-12-08]. https://ncncd.chinacdc.cn/xzzq_1/202101/t20210111_223706.htm. Centre for Prevention and Control of Chronic Non-communicable Diseases of Chinese Center for Disease Control and Prevention, Statistical Information Centre of the National Health Commission of the PRC. China cause of death surveillance dataset[EB/OL]. (2023-12-07)[2023-12-08]. https://ncncd.chinacdc.cn/xzzq_1/202101/t20210111_223706.htm. (in Chinese)
[6]	Word Health Organization. International statistical classification of diseases and related health problems 10th revision (ICD-10)[EB/OL]. (2020-02-01)[2023-11-24]. https:/www.who.int/standards/classifications/classification-of-diseases/list-of-official-icd-10-updates.
[7]	王雪菲, 陆英丽, 孙晓翠, 等. 2009—2019年中国老年人心血管疾病死亡趋势及预测分析[J]. 现代预防医学, 2023, 50(1): 39-45. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202301008.htm WANG X F, LU Y L, SUN X C, et al. Trend and prediction of cardiovascular disease mortality among elderly Chinese, 2009-2019[J]. Mod Prev Med, 2023, 50(1): 39-45. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202301008.htm
[8]	中华人民共和国国务院人口普查办公室, 中华人民共和国国家统计局人口和就业统计司. 中国2010年人口普查资料[M]. 北京: 中国统计出版社, 2012. Office of the National Census of the State Council of the PRC, Department of Population and Employment Statistics of the National Bureau of Statistics of the PRC. China 2010 population census data[M]. Beijing: China Statistics Press, 2012. (in Chinese)
[9]	WONG M C S, HUANG J, CHAN P S F, et al. Global incidence and mortality of gastric cancer, 1980-2018[J]. JAMA Netw Open, 2021, 4(7): e2118457. doi: 10.1001/jamanetworkopen.2021.18457
[10]	张珊, 姜莹莹, 董文兰, 等. 2007—2016年中国居民慢性非传染性疾病死亡水平与变化趋势[J]. 中国慢性病预防与控制, 2018, 26(11): 801-804, 809. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXB201811001.htm ZHANG S, JIANG Y Y, DONG W L, et al. Mortality and trend of chronic non-communicable diseases in China from 2007 to 2016[J]. Chin J Chronic Dis Prev Control, 2018, 26(11): 801-804, 809. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXB201811001.htm
[11]	郭岩松. 《中国慢性病防治工作规划(2012—2015年)》印发[J]. 中国医药导刊, 2012, 14(7): 1100. https://www.cnki.com.cn/Article/CJFDTOTAL-DKYY201207000.htm GUO Y S. Issued of China's Chronic Disease Prevention and Treatment Work Plan (2012-2015)[J]. Chin J Med Guide, 2012, 14(7): 1100. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DKYY201207000.htm
[12]	李志坤, 张茂镕, 杨昭, 等. 昆明市2007—2010年居民慢性病死亡流行特征及PYLL分析[J]. 中国初级卫生保健, 2012, 26(3): 84-86. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW201203041.htm LI Z K, ZHANG M R, YANG Z, et al. The epidemiological characteristics and PYLL analysis of death of chronic diseases among residents in Kunming City in 2007-2010[J]. Chin Prim Health Care, 2012, 26(3): 84-86. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW201203041.htm
[13]	孙立萍, 闫岩, 陈炜. 2017—2020年河南省安阳市慢性病死亡趋势分析[J]. 河南预防医学杂志, 2023, 34(2): 118-122. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF202302009.htm SUN L P, YAN Y, CHEN W. Trend analysis of chronic disease death in Anyang City, Henan Province from 2017 to 2020[J]. Mod Dis J Control Prev, 2023, 34(2): 118-122. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF202302009.htm
[14]	中华人民共和国卫生部关于印发《国家基本公共卫生服务规范(2011年版)》的通知[EB/OL]. (2011-05-24)[2023-07-11]. http//www.nhc.gov.cn/jws/zcwj/201304/cb5978bb42814451a26e5c 97dd855254.shtml. Circular of the Ministry of Health of the PRC on the issuance of the National Norms for Basic Public Health Services(2011 edition)[EB/OL]. (2011-05-24)[2023-07-11]. http//www.nhc.gov.cn/jws/zcwj/201304/cb5978bb42814451a26e5c97dd855254.shtml. (in Chinese)
[15]	中华人民共和国国家卫生和计划生育委员会. 关于印发《国家基本公共卫生服务规范(第三版)》的通知[J]. 中华人民共和国国家卫生和计划生育委员会公报, 2017(3): 21. https://www.cnki.com.cn/Article/CJFDTOTAL-WSGB201703005.htm National Health and Family Planning Commission of the PRC. Notice on Issuing the National Basic Public Health Service Specifications (Third Edition)[J]. Bull Natl Health Fam Plann Commiss PRC, 2017(3): 21. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSGB201703005.htm
[16]	田葳, 李恂, 于海洋, 等. 2013年至2019年沈阳市儿童白血病发病及死亡分析[J]. 现代肿瘤医学, 2023, 31(3): 539-543. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL202303029.htm TIAN W, LI X, YU H Y, et al. Incidence and mortality of childhood leukemia in Shenyang, China from 2013 to 2019[J]. J Mod Oncol, 2023, 31(3): 539-543. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL202303029.htm
[17]	曾新颖, 李镒冲, 刘世炜, 等. 1990—2015年中国四类慢性病早死概率与"健康中国2030"下降目标分析[J]. 中华预防医学杂志, 2017, 51(3): 209-214. ZENG X Y, LI Y C, LIU S W, et al. Analysis of the probability of premature death from four types of chronic diseases and the reduction target of Healthy China 2030 in China from 1990 to 2015[J]. Chin J Prev Med, 2017, 51(3): 209-214. (in Chinese)
[18]	韦荣玉. 环境致癌及其预防[J]. 安全与健康, 2005(7): 48-49. https://www.cnki.com.cn/Article/CJFDTOTAL-LDAQ200507037.htm WEI R Y. Environmental carcinogenesis and its prevention[J]. Safety Health, 2005(7): 48-49. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-LDAQ200507037.htm
[19]	黄渊秀, 胡劲松, 黄霜, 等. 长沙市儿童青少年慢性病患病现状[J]. 公共卫生与预防医学, 2018, 29(5): 70-73. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201805020.htm HUANG Y X, HU J S, HUANG S, et al. Chronic diseases status of children and adolescents in Changsha City[J]. J Public Health Prev Med, 2018, 29(5): 70-73. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201805020.htm