目的 了解中国2008—2021年5岁以下儿童先天性心脏病(先心病)死亡率变化趋势,为制订降低先心病死亡率的相关卫生政策提供重要参考。 方法 收集2008—2021年中国死因监测数据集,采用JoinPoint回归分析5岁以下儿童先心病死亡率的年度变化百分比(APC)和平均年度变化百分比(AAPC)。 结果 2008—2021年,＜1岁婴儿(AAPC＝-8.65,P＜0.001)和1~＜5岁儿童(AAPC＝-9.01,P＜0.001)先心病死亡率均呈下降趋势,但＜1岁婴儿先心病死亡率显著高于1~＜5岁儿童。＜1岁男婴先心病死亡率(AAPC＝-9.11,P＜0.001)下降幅度大于女婴(AAPC＝-7.91,P＜0.001),但男婴死亡率高于女婴。城市＜1岁婴儿的先心病死亡率(AAPC＝-10.69,P＜0.001)下降幅度大于农村(AAPC＝-7.69,P＜0.001),但2018年后农村＜1岁婴儿先心病死亡率反超城市。西部地区1~＜5岁儿童的先心病死亡率(AAPC＝-6.02,P＜0.001)降幅低于东部地区(AAPC＝-11.42,P＜0.001)和中部地区(AAPC＝-8.71,P＜0.001)。 结论 2008—2021年中国5岁以下儿童先心病死亡率逐渐下降,但总体死亡率仍处于较高水平,尤其是婴儿群体。今后应加强先心病的预防和早期筛查,降低先心病的发生率和死亡率。
Abstract
Objective To examine the mortality trends of congenital heart disease (CHD) among children under 5 years old in China from 2008 to 2021, in order to provide critical evidence for developing health policies to reduce CHD mortality. Methods Data were collected from China′s cause of death monitoring system spanning the years 2008 to 2021.The annual percentage change (APC) and average annual percentage change (AAPC) of congenital heart disease mortality rates among children under 5 years old were assessed using JoinPoint regression analysis. Results From 2008 to 2021, both infants (<1 year: AAPC=-8.65, P<0.001) and children (1-<5 years: AAPC=-9.01, P<0.001) showed significant declining trends in CHD mortality, though infant mortality remained substantially higher.Male infants exhibited greater mortality reduction (AAPC=-9.11, P<0.001) than females (AAPC=-7.91, P<0.001), yet maintained higher absolute rates.Urban areas demonstrated steeper declines in infant mortality (AAPC=-10.69, P<0.001) compared to rural areas (AAPC=-7.69, P<0.001), with rural rates surpassing urban after 2018.Western China showed slower mortality reduction in children aged 1-<5 years (AAPC=-6.02, P<0.001) compared with eastern (AAPC=-11.42, P<0.001) and central regions (AAPC=-8.71, P<0.001). Conclusions While CHD mortality among childrenunder 5 years has significantly declined since 2008, rates remain concerningly high, particularly for infants.These findings underscore the need for enhanced nationwide CHD prevention and early screening programs to further reduce disease burden and mortality.
关键词
先天性心脏病 /
5岁以下儿童 /
死亡率 /
JoinPoint回归
Key words
congenital heart disease /
children under 5 years of age /
mortality rate /
JoinPoint regression
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基金
国家自然科学基金资助项目(71964009)
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