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目的利用人群死因回顾调查资料开展居民死亡水平及疾病负担研究,为制定疾病预防控制对策提供科学依据。方法采用居民死亡原因普查方法对2004—2005年2年中10县(市)死亡个案回顾调查,以死亡率和构成比描述居民死亡水平;以伤残调整生命年(DALY)测量疾病负担,死亡损失寿命年(YLL)采用直接法计算,伤残损失寿命年(YLD)采用间接法计算;同时结合人力资本法计算疾病的经济负担。结果云南省10县(市)2004—2005年居民总死亡个案为53 293例,城乡居民总死亡率655.61/10万(标化率701.28/10万),城市630.09/10万(标化率685.39/10万),农村720.40/10万(标化率701.28/10万),城乡居民死亡率较高的年龄段为0～1岁(2 234.38/10万)和≥55岁(1 068.03/10万～24 366.08/10万);全人群前5位死因顺位依次为呼吸系统疾病、损伤和中毒、脑血管病、恶性肿瘤、心脏病。传染性疾病、非传染性疾病、损伤与中毒3大类疾病死亡构成依次为:7.64%(4071/53293)7、6.40%(40716/53293)和15.96%(8 506/53 293);疾病总负担DALY为198.89/千人,全人群前5位疾病负担顺位依次为:损伤和中毒、神经精神性疾病、呼吸系统疾病、脑血管疾病和传染性疾病。传染性疾病、非传染性疾病和损伤与中毒DALY依次为25.65/千人、127.00/千人和46.24/千人,三者在DALY构成所占比例依次为12.90%、63.85%和23.25%;间接经济负担全人群为69 730.84万元,其中传染性疾病、非传染性疾病、损伤与中毒依次为:8 992.89万元,44 526.20万元和16 211.74万元,占间接疾病经济负担构成分别为:12.90%、63.85%和23.25%。结论云南省10县(市)居民死亡原因构成及疾病负担以慢性非传染性疾病为主,慢性非传染性疾病已经成为影响云南省居民健康的主要问题,应适时调整卫生资源,以确保广大群众的健康。
Objective To make use of the cause of death of people to review the survey data to carry out the research on the death level and disease burden of residents and provide a scientific basis for formulating the disease prevention and control measures. Methods A total of 10 deaths from 10 counties were retrospectively surveyed by means of census of residents’ deaths in 2004-2005. The death rate and constituent ratio were used to describe the death rate of residents. The disability-adjusted life year (DALY) was used to measure the burden of disease and death The YLL is calculated using the direct method, the YLD is calculated using the indirect method, and the economic burden of the disease is calculated in conjunction with the Human Capital Law. Results The total number of deaths among residents in 10 counties (cities) of Yunnan Province from 2004 to 2005 was 53,293, with a total urban-rural resident death rate of 655.61 / 100,000 (standardization rate of 701.28 / 100,000) and urban area of 630.09 / 100,000 (standardization rate of 685.39 / 100,000) and 720.40 / 100,000 in rural areas (standardization rate: 701.28 / 100,000). The age groups with higher urban and rural death rates were 0-1 years old (2 234.38 / 100000) and ≥55 years old (1.068.03/10 Million ~ 24366.08 / 100000). The top five causes of death in the whole population were respiratory diseases, injuries and poisonings, cerebrovascular diseases, malignant tumors and heart diseases. Infectious diseases, noncommunicable diseases, injuries and poisoning accounted for 7.64% (4071/53293), 7.64% (40716/53293) and 15.96% (8 506/53, 293), respectively The burden of DALY was 198.89 per thousand. The top 5 burden of disease in the whole population were as follows: injury and poisoning, neuropsychiatric disease, respiratory disease, cerebrovascular disease and infectious disease. Infectious diseases, non-communicable diseases and injuries and poisoning DALY were 25.65 per thousand, 127.00 per thousand and 46.24 per thousand respectively. The proportions of DALY, infectious diseases, non-contagious diseases and poisoning were 12.90%, 63.85% and 23.25% respectively. The economic burden of the entire population was 69 730.84 million yuan, of which infectious diseases, non-communicable diseases, injuries and poisoning were: 89.2989 million yuan, 44526.06 yuan and 16.21474 million yuan, accounting for the indirect economic burden of disease were: 12.90%, 63.85% and 23.25%. Conclusion The causes of death and disease burden among residents in 10 counties in Yunnan Province are mainly chronic non-communicable diseases. Chronic non-communicable diseases have become the main problems that affect the health of residents in Yunnan Province. Health resources should be adjusted in time to ensure that the general public Health.