中国一座转型城市中哮喘的全因负担和病因特异性负担：人口研究
All-Cause and Cause-Specific Burden of Asthma in a Transitioning City in China: Population Study.
作者信息
Cheng Xuelin, Wu Xiaoling, Ye Wenjing, Chen Yichen, Fu Peihua, Jia Wenchang, Zhang Wei, Xu Xiaoyun, Gong Di, Mou Changhua, Gu Wen, Luo Zheng, Jiang Sunfang, Li Xiaopan
机构信息
Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, 180 Fenglin Rd, Xuhui, Shanghai, 200030, China, 86 13621925210.
Department of Respiratory Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
JMIR Public Health Surveill. 2024 Nov 14;10:e44845. doi: 10.2196/44845.
BACKGROUND
Understanding the impact of asthma on public health is crucial for evidence-based prevention and treatment strategies.
OBJECTIVE
This study aimed to identify the causes of asthma-related mortality in Pudong, Shanghai, China, offering insights for managing similar regions or countries in transition.
METHODS
Mortality statistics were obtained from the Vital Statistics System of Pudong for 2005-2021. Temporal patterns for the burden of asthma were examined. The crude mortality rate (CMR), age-standardized mortality rate by Segi's world standard population (ASMRW), and years of life lost (YLL) for both all-cause and asthma-specific deaths were computed. Mortality rates associating with aging and other variables were categorized using the decomposition technique. The autoregressive integrated moving average model was used to forecast the asthma-related death mortality rate by 2035.
RESULTS
A total of 1568 asthma-related deaths occurred during the follow-up period, with the CMR and ASMRW being 3.25/105 and 1.22/105 person-years, respectively. The primary underlying causes of death were chronic lower respiratory diseases, coronary heart diseases, and cerebrovascular disease. The YLL due to total asthma-related deaths added up to 14,837.76 years, with a YLL rate of 30.73/105 person-years. Male individuals had more YLL (8941.81 vs 5895.95 y) and a higher YLL rate (37.12/105 vs 24.38/105 person-years) than female individuals. From 2005 to 2021, the ASMRW declined by 3.48%, and both the CMR and YLL rate decreased in the 0-29, 70-79, and ≥80 years age groups (all P<.01). However, asthma-related deaths increased from 329 people between 2005 and 2008 to 472 people between 2017 and 2021. The proportion of the population aged 80 years and older gradually increased by 1.43% (95% CI 0.20%-2.68%; P=.03), and the mortality rates of asthma deaths attributable to population aging rose by 21.97% (95% CI, 11.58%-33.32%; P<.001) annually.
CONCLUSIONS
Asthma remains a significant public health challenge in transitioning countries, requiring increased attention and resource allocation.
背景
了解哮喘对公众健康的影响对于基于证据的预防和治疗策略至关重要。
目的
本研究旨在确定中国上海浦东新区哮喘相关死亡的原因，为管理处于转型期的类似地区或国家提供见解。
方法
从浦东新区生命统计系统获取2005 - 2021年的死亡率统计数据。研究哮喘负担的时间模式。计算全因死亡和哮喘特异性死亡的粗死亡率（CMR）、基于Segi世界标准人口的年龄标准化死亡率（ASMRW）以及寿命损失年数（YLL）。使用分解技术对与年龄及其他变量相关的死亡率进行分类。采用自回归积分滑动平均模型预测到2035年哮喘相关死亡的死亡率。
结果
随访期间共发生1568例哮喘相关死亡，CMR和ASMRW分别为3.25/10万和1.22/10万人年。主要潜在死因是慢性下呼吸道疾病、冠心病和脑血管疾病。哮喘相关死亡导致的YLL总计达14837.76年，YLL率为30.73/10万。男性的YLL（8941.81对5895.95年）和YLL率（37.12/10万对24.38/10万人年）均高于女性。2005年至2021年，ASMRW下降了3.48%，0 - 29岁、70 - 79岁和≥80岁年龄组的CMR和YLL率均下降（均P<.01）。然而，哮喘相关死亡人数从2005年至2008年的329人增加到2017年至2021年的472人。80岁及以上人口比例逐渐增加1.43%（95%CI 0.20% - 2.68%；P =.03），因人口老龄化导致的哮喘死亡死亡率每年上升21.97%（95%CI，11.58% - 33.32%；P<.001）。
结论
在转型国家，哮喘仍然是一项重大的公共卫生挑战，需要更多关注和资源分配。
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