收集西安地区2014年呼吸系统疾病日死亡人数及同期气象数据,计算分析西安地区每日舒适度指数;应用SPSS17.0对逐日气象要素及舒适度指数与呼吸系统疾病日死亡人数进行单因素相关分析,分析气象要素对呼吸系统疾病日死亡的累积和滞后效应,及不舒适日对呼吸系统疾病死亡的影响,研究西安地区气象因素和舒适度对呼吸系统疾病死亡的影响.结果表明,气温、气压、风速、湿度与呼吸系统日死亡的相关性较显著,且随着累积和滞后时间增加,与呼吸系统日死亡的相关性有逐渐增强的趋势;西安地区日舒适度指数与呼吸系统日死亡人数有显著的负相关关系(r=-0.525,P<0.001);"不舒适日"比"舒适日"日平均死亡率多71％.可见,西安地区气象因素对呼吸系统日死亡的影响具有明显的累积和滞后效应,因寒冷导致的人体不适对呼吸系统的超额死亡有很大影响.

目的 了解2011-2016年西安市居民的主要死因, 分析其主要特征及对居民寿命损失的影响, 为当地行政部门制定相应的疾病防控策略和措施提供数据支持.方法 汇总2011-2016年西安市居民的死亡数据, 通过计算标化死亡率、潜在减寿年数、潜在工作损失年数、去死因期望寿命等指标, 分析影响居民寿命损失的主要原因.用Excel 2007和SPSS 18.0软件对数据进行统计分析.结果 2011-2016年西安市居民的平均死亡率为594.15/10万, 标化死亡率为477.08/10万, 前5位死因顺位依次是:心脏病、脑血管病、恶性肿瘤、呼吸系统疾病及损伤和中毒.人均期望寿命为76.89岁, 心脏病、脑血管病、恶性肿瘤对寿命损失的影响最大, 去除这3类死因, 期望寿命分别增加3.21、2.77和2.48岁.减寿顺位排在首位的是恶性肿瘤, 标化潜在减寿率为7.84‰;工作损失年数顺位排在首位的是损伤和中毒, 标化潜在工作损失率为6.11‰.损伤和中毒的平均减寿年数和平均潜在工作损失年数均为最高, 分别为26.08年/人和22.60年/人.结论 心脑血管疾病和恶性肿瘤是影响西安市居民健康的主要原因, 损伤和中毒致死年龄较轻, 对全市居民的期望寿命构成严重威胁.今后要持续推进全民健康生活方式行动, 加强慢性病的管理和防控, 并尽早开展伤害监测工作, 提高人均期望寿命.

气象因素是心脑血管疾病发病和死亡的诱因之一,近年来我国心脑血管疾病死亡率逐年上升.为了应用气象因素对心脑血管疾病的影响机制,对预测预报心脑血管疾病的发病、发展提供依据,现综述2000年至今的国内外有关气象因素对心脑血管疾病发生和死亡影响及其机制方面的研究,并对目前研究中存在的问题和今后研究方向进行讨论.

Objective To describe the distribution characteristics of injuries,using data from the Xi'an sentinel hospitals in 2015 to develop injury prevention strategy.Methods Cases of injuries were descriptively analyzed based on the data at the sentinel hospitals in 2015.Results Information from 2521 cases was analyzed.The number of male cases outnumbered the females,with sex ratio of 1.70:1.The injury cases in people aged 25-44 years accounted for 40.18％ of the total.The top 3 causes of injuries were the traffic-related (37.56％),knife/sharp instrument (20.39％) and blunt (16.30％).The injuries mainly occurred on the road/street,at home and at industrial and construction sites.Altogether 2036 (80.76％) of the total 2521 reported injury visits were related to at least one product.The main kind of products involved was road transport tools (58.73％).Conclusion The main reasons for injuries were traffic-related,knife/sharp instrument and blunt,especially in young and middle aged population.Special attention should be paid to the blunt injuries.Intervention should be targeted to specific population.

Objective To study the death causes and the epidemic trend of cardiovascular and cerebrovascular diseases in Xi'an city and to provide evidence for the development of prevention and control strategies.Methods Data was derived from the disease death surveillance database during 2010 to 2015.ICD-10 was used to classify the death causes.Software of Excel 2003 and SPSS13.0 were used to collect and analyze the data.The mortality rate,standardized mortality rate,death proportion,annual percent change (APC),PYLL and AYLL were calculated.Results The crude mortality rate due to cardiovascular and cerebrovascular was 310.36/100000,and the standardized mortality rate was 243.84/100 000 in Xi'an city from 2010 to 2015.The male mortality rate was higher than the female (x2 =100.88,P ＜ 0.01).The death rate of cerebrovascular diseases increased significantly (t =7.85,P ＜ 0.01).The death rate of acute myocardial infarction increased significantly (t =8.78,P ＜0.01),but the death rate of hypertensive heart disease,pulmonary heart disease and rheumatic heart disease decreased significantly (all P ＜ 0.05).The mortality rate of cardiovascular and cerebrovascular disease was very low in the residents aged under 35 years,whereas the rate increased with age in the residents at the age of ≥ 35 years old,especially increased sharply after 75.The PYLL due to cardiovascular and cerebrovascular diseases in the death cases from 1-69 years old was totally 420107 person-years,the AYLL was 3.97 person-years,and the PYLL rate was 12.24％.Conclusion Cardiovascular and cerebrovascular disease have emerged as the primary cause of death for Xi'an residents which do harm to the old badly and more attention should be paid for the prevention and control.

目的 了解西安市2002-2014年居民恶性肿瘤死亡特征及变化趋势,为恶性肿瘤防治提供依据.方法 采用西安市2002-2014年死因监测点居民恶性肿瘤死亡登记资料,用ICD-10进行死因分类,计算恶性肿瘤死亡率、标化死亡率、死亡构成比和年度变化百分比(annual percentage change,APC)等描述恶性肿瘤死亡分布特征和变化趋势的指标.结果 西安市2002-2014年死因监测点恶性肿瘤粗死亡率为129.10/10万,标化死亡率为100.19/10万,在全死因中居第3位,男性死亡率高于女性(x2 =3086.45,P＜0.01);恶性肿瘤死亡率标化后显示,全人群、男性和女性死亡率均呈下降趋势(P＜0.05),APC分别为-3.732％、-4.094％和-3.153％;恶性肿瘤死因前5位的是肺癌、肝癌、胃癌、食管癌和肠癌,其中肝癌(APC为-3.369％)粗死亡率呈下降趋势,胃癌在2006-2014年粗死亡率呈上升趋势(APC=2.32％);肺癌、肝癌、胃癌和食管癌标化死亡率呈下降趋势(P＜0.05),APC分别为3.652％、-6.750％、-5.665％、-5.916％.结论 西安市居民恶性肿瘤标化死亡率呈下降趋势,但由于人口老龄化加剧,粗死亡率未表现出下降趋势,仍需加强监测和防治,特别是肺癌、肝癌、胃癌等主要恶性肿瘤的防控.

目的 分析西安市2005-2014年居民主要慢性病死亡特征和流行趋势,为制定适合本地区的慢性病防治策略提供依据.方法 收集西安市2005-2014年居民慢性病死因监测数据,采用死亡数、粗死亡率、标化死亡率、死因构成比、年度变化百分比(APC)等指标对慢性病死亡趋势进行统计学描述.结果 西安市2005-2014年慢性病平均死亡率为451.58/10万(384.82/10万-502.60/10万).恶性肿瘤(APC=2.312％)、心脏病(APC=2.786％)、脑血管病(APC =5.579％)和慢性呼吸系统疾病(APC=6.306％)死亡呈上升趋势(P＜0.05),高血压(APC=-23.489％)的死亡呈下降趋势(P＜0.05),而糖尿病的死亡基本维持在稳定水平.死亡率标化后高血压的死亡仍呈下降趋势外(P＜0.05),其他各慢性病的死亡基本维持在稳定水平.各慢性病的死亡率均随年龄增大呈升高趋势;男性死亡率显著高于女性(x2=3 176.44,P＜0.01).结论 慢性病已成为西安市居民生命健康的主要威胁,防治亟待加强;重点防治的目标人群为中老年人群.

目的 了解国家基本公共卫生服务项目实施以来,西安市高血压管理进展情况以及城乡差别.方法 分析2010-2014年西安市基层医疗卫生机构高血压患者健康管理率、规范管理率和血压控制率等指标变化情况,并采用随机抽样的方法分别调查了7家社区服务中心和乡镇卫生院的700名管理满一年的高血压患者的随访情况,比较城乡高血压患者的管理差异.结果 2014年西安市基层医疗机构高血压健康管理率、规范管理率和血压控制率分别为39.35％、83.15％％和62.60％,高于2010年的对应值(健康管理率、规范管理率和血压控制率分别为15.62％.69.46％和42.34％),差异有统计学意义(P＜0.01).调查显示城市高血压患者血压控制率(67.14％)高于农村患者(55.65％),差异有统计学意义(P＜0.05).结论 西安市实施国家基本公共卫生服务项目高血压规范管理有效提高高血压健康管理率、规范管理率和血压控制率,城区血压控制水平高干农村.

目的 分析西安市5～19岁学龄期青少年伤害死亡原因及变化趋势,为制定伤害干预措施提供依据.方法 收集西安市2008-2014年伤害死亡资料,用ICD-10进行死因分类,计算伤害死亡率、死因构成、年度变化百分比(Annual Percent Change,APC),并进行统计分析.结果 西安市2008-2014年5～19岁青少年伤害平均死亡率为14.01/105,总体呈逐年下降趋势(APC=-3.23％,t=-2.78,P＜0.05);男性青少年伤害死亡率高于女性(x2=111.72,P＜0.01),男童伤害死亡率随年份的增长呈下降趋势(APC=-5.58％,t=-4.04,P＜0.05).前5位伤害死亡原因依次为交通事故、溺水、意外事故、自杀和意外中毒,占该年龄伤害死亡的87.92％.结论 西安市青少年伤害死亡率呈逐年下降趋势,交通事故和溺水是主要死亡原因,要从家庭、学校和社会三方面加强伤害防控,以有效降低青少年伤害死亡率.

目的 了解西安市0～14岁儿童各年龄组的主要死亡原因,为制定防治干预措施提供依据.方法 利用西安市2005-2014年死因监测系统数据,用国际疾病分类标准ICD-10进行疾病分类编码.结果 西安市2005-2014年0～ 14岁儿童平均死亡率为80.15/10万,年均下降4.22％,差异无统计学意义(t=-2.261,P＞0.05).儿童死亡数占全人群死亡数比例呈下降趋势.男孩死亡率(93.58/10万)高于女孩(64.99/10万)(x2=168.90,P＜0.05);0岁～婴儿死亡率最高(666.84/10万),以后随年龄的增加呈下降趋势,10～ 14岁儿童死亡率最低(25.13/10万).围生期有关疾病、损伤中毒和先天性疾病是引起儿童死亡的前3位死因,死亡率分别为18.26/10万,15.60/10万和14.65/10万.机动车交通事故、机动车外意外事故和溺水位居损伤中毒原因的前3位,死亡率分别为3.13/10万,3.07/10万,2.53/10万.结论 围生期有关疾病、损伤中毒和先天性疾病是西安市儿童的主要死因.加强孕产妇保健和新生儿围生期护理,预防儿童伤害,可有效降低0～ 14岁儿童死亡率.

目的 对2010-2013年西安市居民糖尿病死亡水平及其变化趋势进行分析,为糖尿病预防与控制提供参考.方法 收集2010-2013年西安市居民死因监测资料,采用ICD-10编码进行死因分类,分析城乡居民糖尿病死亡水平和变化趋势.结果 2010-2013年西安市糖尿病死亡率波动在11.91/10万～13.67/10万之间,无明显增高趋势,死亡率随年龄的增长而升高,50岁～组增加明显,80岁～组达最高;男女死亡率无显著差别;主城区死亡率高于郊县(x2=33.075,P＜0.001).主城区男性糖尿病死亡率显著高于女性(x2=5.202,P=0.023);郊县男女性死亡率差异无统计学意义(x2=3.382,P=0.066).结论 西安市居民糖尿病死亡率呈波动变化趋势,男女之间死亡水平差异无统计学意义,城乡之间死亡水平有差别.

目的 了解西安市成年人高血压患病率、知晓率、治疗率和控制率情况,为高血压综合防治工作提供依据.方法 于2013年11月用多阶段整群抽样法调查西安市14个区县18岁及以上在该地居住6个月以上的居民共8 193人.通过问卷调查和体格检查获取调查对象的基本信息和健康状况,体格检查包括测量血压、身高和体重等.结果 西安市成年人高血压标化患病率为21.2％,男性为22.4％,女性为19.9％,城区和郊县分别为20.4％和22.0％.高血压知晓率为63.8％(男性为58.3％,女性为69.5％,城区为65.6％,郊县为62.0％),治疗率为47.5％(男性为42.8％,女性为52.4％,城区为52.5％,郊县为42.7％),控制率为17.8％(男性为15.4％,女性为20.3％,城区为23.8％,郊县为12.1％),经治疗的高血压患者控制率为37.6％.在高血压知晓者中,仅73.5％按医嘱服药,23.8％为有症状时服药;采取控制饮食、运动和血压监测者分别占26.9％、26.8％和29.5％.结论 西安市成年人高血压的患病率比较高,而高血压治疗率和控制率偏低,尤其是在郊县和男性中,需进一步加强高血压防治健康教育,特别是非药物治疗.

目的 了解西安市成年人群糖尿病患病率和糖尿病患者知晓率、治疗率和控制率情况,为糖尿病综合防治工作提供依据.方法 利用多阶段整群抽样法,于2013年11月调查西安市全市14个区县18岁及以上在该地居住6个月以上的居民共8 196人.通过问卷调查和体格检查获取调查对象的基本信息和健康状况,体格检查包括测量空腹血糖和身高、体重等指标.结果 西安市成年人糖尿病标化患病率为7.8％(男性7.9％,女性7.6％;城区7.6％,郊县7.9％).糖尿病患者知晓率为49.8％(男性52.5％,女性47.3％;城区58.1％高于郊县41.6％,P＜0.05),治疗率为41.8％(男性43.0％,女性40.5％;城区47.5％高于郊县的36.0％,P＜0.05),控制率为14.3％(男性11.4％低于女性17.1％,P＜0.05);城区17.7％高于郊县10.9％,P＜0.05)),经药物治疗的糖尿病患者控制率为28.7％.结论 西安市成年人糖尿病的患病率比较高,而糖尿病患者知晓率、治疗率和控制率偏低,尤其是郊县,需进一步加强糖尿病防治健康教育.

Objective To disseminate the knowledge about diabetes prevention among community residents through the training program , raise the awareness of health. Methods Community residents were tested by diabetes knowledge questionnaire before and after the training respectively , and data were analyzed by SPSS 18.0. Results The average score was higher after the training.The scores of townsmen were higher than countrymen before and after the training.Before the training , the score of residents above 60 years old was higher than residents below 50 and aged 51-60 , and after the training there was no significant difference.Before the training , the score of diabetes group was higher than high-risk population group and general population group ; after the training , the score of high-risk population group was higher than general population group. Conclusions It is necessary to disseminate the knowledge about diabetes prevention among community residents.In further training , countryman and high-risk population training should be reinforced.And to different population targeted interventions and health promotion activities should be taken.

The authors conducted a time-series analysis to examine seasonal variation of mortality risk in association with particulate matter less than 2.5 μm in aerodynamic diameter (PM(2.5)) and chemical species in Xi'an, China, using daily air pollution and all-cause and cause-specific mortality data (2004-2008). Poisson regression incorporating natural splines was used to estimate mortality risks of PM(2.5) and its chemical components, adjusting for day of the week, time trend, and meteorologic effects. Increases of 2.29% (95% confidence interval: 0.83, 3.76) for all-cause mortality and 3.08% (95% confidence interval: 0.94, 5.26) for cardiovascular mortality were associated with an interquartile range increase of 103.0 μg/m(3) in lagged 1-2 day PM(2.5) exposure. Stronger effects were observed for the elderly (≥65 years), males, and cardiovascular diseases groups. Secondary components (sulfate and ammonium), combustion species (elemental carbon, sulfur, chlorine), and transition metals (chromium, lead, nickel, and zinc) appeared most responsible for increased risk, particularly in the cold months. The authors concluded that differential association patterns observed across species and seasons indicated that PM(2.5)-related effects might not be sufficiently explained by PM(2.5) mass alone. Future research is needed to examine spatial and temporal varying factors that might play important roles in modifying the PM(2.5)-mortality association.

Objective To study associations between daily mortality and exposure to air pollution.Methods A time-series analysis was conducted to assess the acute mortality effects of respirable particulate matter(PM10),nitrogen dioxide(NO2)and sulfur dioxide(SO2) in urban Xi'an residents,using Poisson regression.Temperature,relative humidity,age,gender and day of week were controlled in the models.Results Per 10 μg/m3 increases in 2-day average concentrations of air pollution,significant increases were observed in all-cause mortality of 0.35%(95%CI: 0.11%-0.58%) for PM10,2.42%(95%CI: 1.57%-3.27%) for NO2,and 0.60%(95%CI: 0.16%-1.05%) for SO2.Stronger effects of air pollution were observed on cardio-respiratory mortality.Seasonal variations in pollution associated mortality effects were found between centralized heating(November 15 to March 15) and non-heating(March 16 to November 14) periods.Conclusion Exposure to ambient pollution was significantly associated with the increases in excess risk of total and cardio-respiratory mortality in Xi'an residents.

[Objective]To compare the causes of death in residents living in different areas in Xi'an.[Methods]Standard mortality rate(SMR),sequence of cause of death,average years of life lost(AYLL)and life lost rate were used to analyze causes of death in urban,fringe and rural areas in Xi'an from 2007 to 2008.[Results]SMR of the residents living in fringe area from 2007 to 2008 was 569.87/105,which was higher than the SMR in urban and rural areas;the comparison result of SMRs of malignant tumor showed significant difference(fringe area﹥urban area﹥rural area),the comparison result of SMRs of lung cancer also showed significant difference(fringe area﹥urban area﹥rural area);SMRs of traffic accidents,poisoning,suffocation,crash to death and electric shock etc.in fringe area were significant higher than those in urban and rural areas,while the SMRs of falling,drowning and suicide in rural area were significant higher than those in urban and fringe areas.Accidental death took a lead in fringe and rural areas with the life lost rate of 17.69% and 9.97% respectively.[Conclusion]In order to reduce mortality rate of the residents in Xi'an,it is necessary to strengthen the administration of both natural and social environment.

目的:通过对一起上呼吸道感染引起的爆发疫情的调查与处理,探讨学校呼吸道传染病尤其是流感爆发的预防控制措施.方法:对患者进行流行病学调查,资料输入SPSS数据库、对急性期患者采样进行流感的实验室检测,对照监测哨点医院流感的检出情况,判断西安地区的流感流行趋势,同时探讨控制措施的效果.结果:此次发生的上呼吸道感染爆发疫情为B型流感爆发.结论:2006年至2007年冬季西安地区流感流行的优势毒株为B型流感病毒,且易于在农村地区发生爆发疫情.采取停课、隔离、积极治疗患者等措施对于及时控制疫情是至关重要的.

目的:了解不同社区人群高血脂意识。方法:采用问卷式方法面对面调查,选择城市居民和农村乡镇两个不同类型的社区,每个社区随机抽取1500人,共计3000人。结果:认为40岁以上的人应该每年常规检查血脂、高血脂会引起哪些疾病、哪些方法能预防高血脂的正确回答率城市社区均明显高于农村社区(P<0.01)。城市社区和农村社区曾经做过血脂检查的人分别为20.1%和1.4%,平均为9.3%,做过血脂检查的人中,平均有31.6%的人被告知血脂高于正常水平。超重或肥胖者被告知有高血脂的比例明显高于体重指数正常的人(P<0.01)。结论:城市社区的人群高血脂意识高于农村社区人群。

为评价西安市居民死亡水平,确定主要死因的分布及其变化趋势,现将2003年西安市全死因资料进行了分析.