目的：分析2009—2013年苏州20岁及以上居民冠心病发病率变化趋势及其类型，为本地的冠心病防治工作提供参考依据。方法收集苏州市公共卫生监测系统2009—2013年慢性病监测数据库和年度报表资料，按年度、性别、年龄计算冠心病粗发病率和标化发病率。以2009—2013年的各年度累计新发病例数与累计人口数之比计算平均发病率。结果2009—2013年苏州20岁及以上居民冠心病平均粗发病率为171.2／10万（46334／27061706），平均标化发病率为118.8／10万；男性冠心病平均粗发病率和平均标化发病率分别为194.1／10万（25726／13256950）和137.8／10万；女性冠心病平均粗发病率和平均标化发病率分别为149.3／10万（20608／13804757）和100.1／10万。男性冠心病平均粗发病率和平均标化发病率均高于女性（χ2＝793.20、151423.46， P＜0.01）。2009—2013年苏州20岁及以上男性、女性冠心病粗发病率和标化发病率均呈上升趋势（ P＜0.001）；男性和女性粗发病率年平均增长速度分别为5.18％和7.06％，标化发病率年平均增长速度分别为2.17％和5.35％；女性标化发病率年平均增长速度高于男性（χ2＝57.31， P＜0.01）。随着年龄的增长，冠心病发病率呈上升趋势（P＜0.001）；20～49岁居民冠心病发病率年平均增长速度为6.37％；2009—2013年60岁及以上老年人冠心病新发病例占累计新发病例总数的83.5％（38697／46334）。冠心病发病类型以心绞痛（57.2％，7845／13704）和急性心肌梗死（38.7％，5302／13704）为主；冠心病猝死构成比年平均增长速度为6.12％。结论2009—2013年苏州20岁及以上居民冠心病发病率随年龄增长而增加，冠心病类型主要为心绞痛和急性心肌梗死，发病年龄年轻化，老年人和女性发病率较高值得关注。%Objective To analyze the incidence , type and dynamic trend of coronary heart disease ( CHD ) in the population over the age of 20 in Suzhou so as to provide the scientific foundation for the prevention and control of CHD in Suzhou.Methods Data on chronic diseases surveillance and annual reports from 2009 to 2013 in Suzhou public health surveillance system were collected .The crude incidence rate and standardized incidence rate were calculated with regard to the year, gender and age.The average incidence rate was calculated from the ratio of accumulative total new cases to accumulative total population from 2009 to 2013, respectively.Results The average CHD crude incidence rate and the age standardized incidence rate for 5 years in the population over the age of 20 in Suzhou from 2009 to 2013 was 171.2/100 000 ( 46 334/27 061 706) and 118.8/100 000 respectively.The average CHD crude incidence rate and the age standardized incidence rate of the males was 194.1/100 000 ( 25 726/13 256 950 ) and 137.8/100 000 respectively , and the females , 149.3/100 000 (20 608/13 804 757) and 100.1/100 000 respectively.The CHD crude incidence rate and the age standardized incidence rate of the males were higher than those of the females respectively (χ2 =793.20, 151 423.46, P<0.01 ) .It showed significant increasing trends of the crude CHD incidence rates and the age standardized incidence rates in both males and females ( P<0.001) .From 2009 to 2013, the average annual growth rates of the crude CHD incidence rates of males and females were 5.18%and 7.06%respectively , and the age standardized incidence rates , 2.17%and 5.35%respectively.It showed that the average annual growth rate of the age standardized incidence rate of the females was higher than the males (χ2 =57.31, P<0.01) .The CHD incidence rate showed significant increasing trend with the age (P<0.001) .The average annual growth rate of CHD incidence rate of 20-49 years old residents was 6.37%.The accumulated constituent ratio of old sufferers over the age of 60 was 83.5%(38 697/46 334) from 2009 to 2013.The types of the CHD mainly consisted of angina (57.2%, 7 845/13 704) and acute myocardial infarction ( 38.7%, 5 302/13 704 ) .The average annual growth rate of the constituent ratio of sudden coronary death was 6.12%.Conclusion The incidence rate of CHD in the population over the age of 20 in Suzhou shows a increasing trend with age , characterized by the angina and acute myocardial infarction as the main types of the CHD .The younger trend of onset age of patients with CHD , higher incidence rate of CHD in elder population and the higher increasing trend of the incidence rate of CHD in the females should be concerned .
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