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目的 研究上海市主要慢性非传染性疾病 (慢病 )的死亡率的长期时间趋势。方法 上海市死因登记系统自 5 0年代已开始收集人口学资料和死亡资料。死亡率的时间趋势分析采用线性回归统计模型。结果 1998年上海市平均期望寿命增长到 77.0 3岁 ,居民调整死亡率呈持续下降趋势 ,前三位死因分别为循环系统疾病、肿瘤、呼吸系统疾病 ,已占总死亡的 75 .42 %。慢病的死亡顺位在不断提高。慢病的粗死亡率呈逐年上升趋势 ,但是 ,上海市慢病的调整死亡率趋势不尽相同。慢性阻塞性肺病的调整死亡率持续下降 ,糖尿病则持续上升 ;肿瘤、脑血管病、心血管病调整死亡率则先升后降 ,与粗死亡率趋势形成明显的剪刀差 ,转折点分别发生于 2 0世纪 70年代中期、80年代末期和 90年代初期。分部位的肿瘤中 ,仅直肠肿瘤和乳腺癌未见明显下降。结论 人口的老龄趋势已是上海市慢病粗死亡率出现上升趋势的主要影响因素。上海市主要慢病的死亡率在经历了近 30年的上升趋势后 ,已出现下降。提示在近 2 0年主要慢病预防控制已取得成效 ,但并不提示与膳食和行为习惯有关的危险因素正在减少
Objective To study the long-term trend of the mortality rate of major chronic non-communicable diseases (chronic diseases) in Shanghai. Methods Shanghai cause of death registration system since the 1950s has begun to collect demographic data and death information. Time trend analysis of mortality using linear regression statistical model. Results In 1998, the average life expectancy in Shanghai increased to 77.0 3 years. Residents’ adjusted mortality rate continued to decline. The top three causes of death were circulatory diseases, cancer and respiratory diseases, accounting for 75.42% of the total. The chronic illness is on the rise. The crude mortality rate of chronic diseases shows an increasing trend year by year, however, the adjusted mortality rate of chronic diseases in Shanghai is not the same. Mortality of chronic obstructive pulmonary disease (COPD) continued to decrease and diabetes mellitus continued to increase. The adjusted mortality rate of cancer, cerebrovascular disease and cardiovascular disease firstly increased and then decreased, with the trend of crude mortality forming obvious scissors difference. The turning points occurred at 20 The mid-70s, the late 80s and early 90s. Sub-part of the tumor, only the rectal tumor and breast cancer no significant decline. Conclusion The aging trend of the population is the main influencing factor of the upward trend of the rough death rate of chronic diseases in Shanghai. The mortality rate of major chronic diseases in Shanghai has declined after experiencing the upward trend of nearly 30 years. Suggesting that major chronic disease prevention and control has achieved some success in the recent 20 years but does not suggest that the risk factors associated with diet and behavioral habits are decreasing