摘要：

目的 分析1990 和2015 年天津市脑卒中死亡率以及疾病负担的变化趋势。方法 利用2015 年全球疾病负担研究中国分省结果，采用死亡例数、死亡率以及伤残调整寿命年（DALY）、因早死所致的寿命损失年（YLL）、残疾所致的健康寿命损失年（YLD）作为疾病负担的主要指标，比较1990 和2015 年天津市脑卒中死亡率和疾病负担变化。结果 2015 年天津市脑卒中死亡率为101.53/10 万，标化死亡率为117.73/10 万，其造成的DALY、YLL 和YLD 分别为285 558.36、265 627.77 和19 930.60 人年，标化DALY 率、YLL 率和YLD 率分别为1870.55/10 万、1746.63/10 万和123.92/10 万；与1990 年相比，2015 年脑卒中死亡例数、DALY、YLL 和YLD 分别增加26.24%、9.05%、5.48%和98.63%，而标化死亡率、DALY率、YLL 率和YLD 率分别下降46.75%、52.81%、54.32%和11.20%。1990 和2015 年天津市出血性卒中DALY、YLL 高于，YLD 低于缺血性卒中；与1990 年相比，2015 年天津市出血性卒中DALY 降低11.77%、YLL 降低14.75%、YLD 增加96.87%，缺血性卒中DALY 增加47.38%、YLL 增加44.04%、YLD 增加100.08%。结论 天津市脑卒中疾病负担越来越严重，尤其是缺血性卒中，且男性疾病负担重于女性。

关键词: 卒中, 死亡率, 患病代价, 天津, 流行病学研究

Abstract:

Objective To analyze the changes of mortality and disease burden of stroke in 1990 and 2015 in Tianjin. Methods The results of the Global Burden of Diseases Study 2015 (GBD 2015) for Chinese estimated by province were used to describe the disease burden of stroke in Tianjin. The analysis index included number of death, mortality rate, disability adjusted life year (DALY), years of life lost (YLL) and years lost due of disability (YLD). The change from 1990 to 2015 for all indexes was used to describe the transitions of disease burden of stroke in the past 25 years in Tianjin. Results In 2015, the mortality rate of stroke reached 101.53 per 100 000 people and the age-standardized mortality rate was 117.73 per 100 000 people. The DALY, YLL, and YLD reached 285 558.36, 265 627.77 and 19 930.60 person year, respectively, and the age - standardized DALY rate, YLL rate and YLD rate were 1870.55, 1746.63 and 123.92 per 100 000 people. Compared with the result in 1990, the number of death, DALY, YLL and YLD in 2015 were increased by 26.24%, 9.05%, 5.48% and 98.63%, respectively, while the age-standardized mortality rate, DALY rate, YLL rate and YLD rate in 2015 were decreased by 46.75%, 52.81%, 54.32% and 11.20%, respectively. In different types of stroke, DALY and YLL of hemorrhagic stroke were higher, while YLD was lower than ischemic stroke in 1990 and 2015. Compared with 1990, DALY was decreased by 11.77%, YLL was decreased by 14.75%, and YLD was increased by 96.87% in hemorrhagic stroke in 2015, while DALY was increased by 47.38%, YLL was increased by 44.04% and YLD was increased by 100.08% in ischemic stroke in 2015. Conclusions Disease burden of stroke became more and more serious in Tianjin, of which the ischemic stroke was most serious, and the disease burden of stroke in men was greater than that in women.

Key words: Stroke, Mortality, Cost of illness, Tianjin, Epidemiologic studies