【摘要】 目的 探索控制4类主要慢性病死亡率可带来的期望寿命提升空间，为全面推进慢性病防控提供依据。方法 利用第七次人口普查的出生和死亡资料和上海市某区的人群慢性病死亡构成资料，预设四类主要慢性病（恶性肿瘤、糖尿病、心脑血管疾病和慢性呼吸系统疾病）死亡率降低的6种模式。模型1假设各个年龄段慢性病死亡率均下降1/3，模型2假设从45岁开始显示预防效果，45岁之后各年龄段死亡率下降1/3。模型3假设各个年龄段慢性病死亡率均下降1/2，模型4假设从45岁开始显示预防效果，45岁之后各年龄段死亡率下降1/2。模型5假设各个年龄段的死亡率中，心血管疾病死亡率下降60%，恶性肿瘤死亡率下降75%，糖尿病死亡率下降60%，慢性呼吸系统疾病死亡率下降70%，模型6假设从45岁开始显示预防效果，45岁之后各年龄段4类主要慢性病死亡率以模型5中的比例下降。以简略寿命表法计算全人群以及不同年龄段人群的期望寿命，并分别计算四类主要慢性病的去死因期望寿命。结果 假设45岁以上各年龄段的主要慢性病死亡率分别下降1/3和1/2，人群期望寿命相应增加4.0和7.2岁。假设45岁以上各年龄段的4类主要慢性病死亡率下降到理想水平，期望寿命增加可达11.5岁，85岁及以上人群期望寿命增加比45～49岁人群多5.7岁。与自0岁组开始下降相比，主要慢性病的死亡率自45岁开始下降预计增加的期望寿命少0.1岁。心脑血管疾病去死因期望寿命最高（94.9岁）。男性恶性肿瘤去死因期望寿命高于女性1.4岁，慢性呼吸系统疾病去死因期望寿命高于女性0.6岁，女性心脑血管疾病去死因期望寿命高于男性4.4岁。结论 通过有效落实现有慢性病防控措施，可显著降低45岁以上人群的慢性病死亡率，从而明显延长其期望寿命。慢性病死亡风险控制对高龄者的期望寿命上升影响更大。由心脑血管疾病死亡率下降所致的期望寿命增长最多。更多还原

【Abstract】 Objective To explore the potential for life expectancy gains from controlling mortality rates for four major chronic diseases,and provide the evidence for comprehensive chronic disease prevention and control. Methods The data of birth and death in the seventh population census and the data of chronic disease mortality composition in a district of Shanghai were used to identify six models of reducing mortality of the four major chronic diseases(malignant tumors,diabetes,cardiovascular and cerebrovascular diseases,and chronic respiratory diseases). Model 1 assumed a one-third reduction in chronic disease mortality across all age groups;model 2 assumed that the preventive effect started at age 45 and mortality decreased by one third in each age group after age 45. Model 3 assumed that the chronic disease mortality rate decreased by half in all age groups. Model 4 assumed that the preventive effects started at age 45 and that mortality rates decreased by half in each age group after age 45. Model 5assumed that the mortality rate of cardiovascular and cerebrovascular disease decreased by 60%,malignant tumor mortality rate decreased by 75%,diabetes mortality rate decreased by 60%,and chronic respiratory disease mortality rate decreased by 70% in each age group. Model 6 assumed that the preventive effects started at age 45,and the mortality rates for the four major chronic diseases in each age group after age 45 decreased by the same proportion as in model 5. The life expectancy of the whole population and different age groups was calculated by abridged life tables,the life expectancy after removing death cause for the four major chronic diseases was calculated separately. Results If mortality rates for major chronic diseases declined by one-third or one-half in individuals aged ≥45,life expectancy increased by 4.0 and 7.2 years respectively. Achieving ideal mortality reductions for all four diseases in those aged ≥45 could increase life expectancy by up to 11.5 years,with the ≥85 age group gaining 5.7 more years than the 45-49 group. Mortality of major chronic diseases declined from age 45 and life expectancy was expected to increase 0.1 years less than it had declined since age 0. Cardiovascular and cerebrovascular disease elimination yielded the highest life expectancy(94.9 years). Males gained 1.4 more years from tumor elimination and 0.6 more years from respiratory disease elimination than females,while females gained 4.4 more years from cardiovascular and cerebrovascular disease elimination. Conclusion By effectively implementing existing chronic disease prevention and control measures,the mortality rate from chronic diseases among people aged 45 and above can be significantly reduced,thereby markedly increasing their life expectancy. The risk control of chronic disease mortality has a greater impact on the increase in life expectancy of the elderly. Life expectancy due to the decline in cardiovascular and cerebrovascular disease mortality increases the most.更多还原