Wang Zhenkun, Hu Songbo, Sang Shuping, Luo Lisha, Yu Chuanhua
From the School of Public Health (Z.W., S.H., L.L., C.Y.) and Global Health Institute (C.Y.), Wuhan University, China; School of Medicine, Yunnan University, Kunming, China (S.S.); and The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus (Z.W.).
Stroke. 2017 Feb;48(2):271-275. doi: 10.1161/STROKEAHA.116.015031. Epub 2016 Dec 13.
Stroke has been the leading cause of death in China. The aim of this study is to assess the long-term trends of stroke mortality in China between 1994 and 2013.
The mortality data were obtained from the GBD 2013 (Global Burden of Disease Study 2013) and were analyzed with the age-period-cohort framework.
We found that the net drift was -2.665% (95% confidence interval, -2.854% to -2.474%) per year for men and -4.064% (95% confidence interval, -4.279% to -3.849%) per year for women, and the local drift values were below 0 in all age groups (P<0.05 for all) in both sexes during the period of 1994 to 2013. In the same birth cohort, the risk of death from stroke rose exponentially with age for both sexes after controlling for period deviations. The estimated period and cohort relative risks were found in similar monotonic downward patterns (significantly with P<0.05 for all) for both sexes, with more quickly decreasing for women than for men during the whole period (significantly with P<0.05 for both).
The decreased mortality rates of stroke in China are likely to be related to improvements in medical care and techniques, spectacular economic growth and fast urbanization, and better early life nutrition conditions of Chinese people. Besides, better education and better awareness of stroke-related knowledge in successive generations could also probably play a role.
在中国，中风一直是主要死因。本研究旨在评估1994年至2013年间中国中风死亡率的长期趋势。
死亡率数据取自《2013年全球疾病负担研究》（GBD 2013），并采用年龄-时期-队列框架进行分析。
我们发现，男性每年的净漂移率为-2.665%（95%置信区间为-2.854%至-2.474%），女性每年的净漂移率为-4.064%（95%置信区间为-4.279%至-3.849%）。在1994年至2013年期间，所有年龄组的局部漂移值在两性中均低于0（所有P<0.05）。在同一出生队列中，在控制时期偏差后，男女因中风死亡的风险均随年龄呈指数上升。估计的时期和队列相对风险在两性中均呈现类似的单调下降模式（所有P<0.05），在整个时期内女性下降速度比男性更快（两者P<0.05）。
中国中风死亡率的下降可能与医疗保健和技术的改善、显著的经济增长和快速的城市化以及中国人更好的早期生活营养状况有关。此外，连续几代人更好的教育和对中风相关知识的更好认知也可能起到了作用。
