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Article(id=1322609121380123158, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506398, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750694400000, receivedDateStr=2025-06-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793264187426, onlineDateStr=2026-10-29, pubDate=1764000000000, pubDateStr=2025-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793264187426, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793264187426, creator=13701087609, updateTime=1793264187426, updator=13701087609, issue=Issue{id=1322609030938346427, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='22', pageStart='4033', pageEnd='4224', issueExtLink='null', onlineDate='null', pubDate='1764000000000', pubDateStr='2025-11-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793264165863, creator='13701087609', updateTime=1793264299902, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609593264489401, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609593264489402, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322609030938346427, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4188, endPage=4193, ext={EN=ArticleExt(id=1322609122177040920, articleId=1322609121380123158, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics and temporal trends of lower respiratory infections mortality among the population aged ≥60 years, China, 2010-2021, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemiological characteristics and temporal trends in Lower Respiratory Infections（LRIs）mortality among population aged ≥60 years in China from 2010 to 2021, providing evidence for formulating and optimizing prevention and control strategies to reduce LRIs-related deaths.

Methods

LRIs mortality data for population ≥60 years were collected from the National Disease Surveillance System Cause of Death Surveillance Dataset（2010-2012）and the Chinese Cause of Death Surveillance Dataset（2013-2021）by sex, urban-rural residence, region, and age group. Mortality rates were standardized using the 2010 National Population Census data. Crude and age-standardized mortality rates were calculated to describe the mortality status of LRIs. Joinpoint 5.4.0.0 software was used to calculate the annual percent change（APC）and average annual percent change（AAPC）to analyze the temporal trends, and the chi-squared test was applied to compare mortality rates across groups.

Results

From 2010 to 2021, a total of 255 385 LRIs deaths occurred among the monitored population aged ≥60 years in China, accounting for 87.65% of all LRIs deaths. The overall crude mortality rate was 57.45 per 100 000 population, with males（63.07/100 000）having a significantly higher mortality rate than females（52.15/100 000）, urban areas（77.95/100 000）higher than rural areas（47.04/100 000）, and the western region（66.10/100 000）higher than the eastern（59.83/100 000）and central（48.17/100 000）regions（all P<0.001）. The age-standardized mortality rate for LRIs among population aged ≥60 years showed an overall downward trend from 2010 to 2020（AAPC=-8.25%, P<0.001）. Similar trends were observed in males（AAPC=-7.77%, P<0.001）, females（AAPC=-9.04%, P<0.001）, urban areas（AAPC=-8.02%, P<0.001）, the eastern region（AAPC =-7.79%, P<0.001）, and the central region（AAPC=-8.58%, P<0.001）, while rural（AAPC=-8.04%, P<0.001）and western regions（AAPC=-8.09%, P<0.001）exhibited steady declines. Among the population aged ≥60 years, LRIs mortality increased significantly with age, while the magnitude of decline showed an upward trend. The AAPCs for the age groups 65-69, 70-74, 75-79, 80-84, and ≥85 years were -3.16%, -5.76%, -6.60%, -8.33%, and -9.90%, respectively（all P<0.05）.

Conclusion

From 2010 to 2021, the mortality rate of LRIs among population aged ≥60 years in China showed a downward trend, which increased significantly with age and showed marked disparities by sex, age, urban/rural residence, and geographic region.The elderly males in urban and western regions are high-risk groups for LRIs-related deaths and require focused attention and targeted control measures.

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目的

分析2010—2021年中国60岁及以上人群下呼吸道感染（Lower Respiratory Infections, LRIs）死亡流行特征及变化趋势，为制定和优化防控措施，降低LRIs死亡提供参考依据。

方法

在《全国疾病监测系统死因监测数据集（2010—2012）》和《中国死因监测数据集（2013—2021）》分性别、城乡、地区及年龄收集≥60岁人群LRIs死亡数据，以2010年全国人口普查数据进行标化，分析死亡率和标化死亡率描述LRIs的死亡状况，采用Joinpoint 5.4.0.0软件计算年度变化百分比（Annual Percent Change，APC）和平均年度变化百分比（Average Annual Percent Change，AAPC）分析变化趋势，组间死亡率比较采用χ2检验。

结果

2010—2021年我国监测≥60岁人群LRIs死亡255 385人，占全人群LRIs死亡的87.65%，总体死亡率为57.45/10万，男性（63.07/10万）死亡率高于女性（52.15/10万），城市（77.95/10万）死亡率高于农村（47.04/10万），西部（66.10/10万）地区死亡率高于东部（59.83/10万）和中部（48.17/10万）地区（均P<0.001）。2010—2021年我国≥60岁人群LRIs标化死亡率总体呈下降趋势（AAPC=-8.25%，P<0.001），男性（AAPC=-7.77%，P<0.001）、女性（AAPC=-9.04%，P<0.001）、城市（AAPC=-8.02%，P<0.001）、东部（AAPC=-7.79%，P<0.001）和中部（AAPC=-8.58%，P<0.001）地区标化死亡率阶段变化趋势与总体基本一致，农村（AAPC=APC=-8.04%，P<0.001）和西部（AAPC=APC=-8.09%，P<0.001）地区LRIs标化死亡率稳定下降。在≥60岁人群中，随年龄的增长，LRIs死亡率显著升高，下降幅度呈递增趋势，在65~69岁、70~74岁、75~79岁、80~84岁、≥85岁年龄组中AAPC分别为-3.16%、-5.76%、-6.60%、-8.33%、-9.90%（均P<0.05）。

结论

2010—2021年我国60岁及以上人群LRIs死亡率呈下降趋势，LRIs死亡率随年龄的增长而升高，存在显著的性别、年龄、城乡及地区差异，城市和西部地区男性高龄人群是LRIs死亡高危人群，需给予重点关注和控制。

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丁旭（1993—），男，硕士，医师，研究方向：疾病预防与控制

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李杨，E-mail：
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China CDC Wkly, 2024, 6 (28): 684-688., articleTitle=Age, sex, and Disease-Specific mortality contributions to Life expectancy in urban and rural China, 1987-2021, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322609125964497439, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, xref=1., ext=[AuthorCompanyExt(id=1322609125972886048, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, companyId=1322609125964497439, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute for Endemic Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou 550004, China), AuthorCompanyExt(id=1322609125981274657, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, companyId=1322609125964497439, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州省疾病预防控制中心地方病防治研究所，贵州　贵阳　550004)]), AuthorCompany(id=1322609126044189218, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, xref=2., ext=[AuthorCompanyExt(id=1322609126052577827, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, companyId=1322609126044189218, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中华预防医学会第二期公共卫生青年精英高级研修项目)])], figs=[ArticleFig(id=1322609127818379831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=EN, label=Fig.1, caption=Trends in number of deaths and mortality rates of LRIs by sex and age group among population aged ≥60 years in China, 2010-2021, figureFileSmall=XelIbix7leYAibAATDjBHw==, figureFileBig=hepSJ0AJbqUZMGaHQFcgpg==, tableContent=null), ArticleFig(id=1322609128044872248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=CN, label=图1, caption=2010—2021年中国≥60岁人群分性别、年龄组LRIs死亡数与死亡率变化趋势, figureFileSmall=XelIbix7leYAibAATDjBHw==, figureFileBig=hepSJ0AJbqUZMGaHQFcgpg==, tableContent=null), ArticleFig(id=1322609128489468473, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=EN, label=Table 1, caption=

Death distribution of LRIs among population aged ≥60 years in China, 2010-2021

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分组累计死亡数累计监测人口数死亡率（/10万）χ2值P值
性别男136 071215 759 66563.072 305.976<0.001
女119 314228 803 29652.15
城乡城市116 670149 681 70577.9516 516.252<0.001
农村138 715294 881 25647.04
地区东部112 129187 409 03559.833 832.107<0.001
中部71 777149 019 65348.17
西部71 479108 134 27366.10
年龄（岁）60~6410 267141 381 2567.261 070 319.780<0.001
65~6914 736109 861 59013.41
70~7422 34878 707 10328.39
75~7935 95857 911 35762.09
80~8458 31836 363 752160.37
≥85113 75820 337 903559.34
合计255 385444 562 96157.45
), ArticleFig(id=1322609129995223610, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=CN, label=表1, caption=

2010—2021年中国≥60岁人群LRIs死亡分布

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分组累计死亡数累计监测人口数死亡率（/10万）χ2值P值
性别男136 071215 759 66563.072 305.976<0.001
女119 314228 803 29652.15
城乡城市116 670149 681 70577.9516 516.252<0.001
农村138 715294 881 25647.04
地区东部112 129187 409 03559.833 832.107<0.001
中部71 777149 019 65348.17
西部71 479108 134 27366.10
年龄（岁）60~6410 267141 381 2567.261 070 319.780<0.001
65~6914 736109 861 59013.41
70~7422 34878 707 10328.39
75~7935 95857 911 35762.09
80~8458 31836 363 752160.37
≥85113 75820 337 903559.34
合计255 385444 562 96157.45
), ArticleFig(id=1322609130142024251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=EN, label=Table 2, caption=

Trends in SMR for LRIs by sex, age group, and region among population aged ≥60 years in China, 2010-2021（per 100 000）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男性女性城市农村
2010128.6091.82134.8986.32
2011127.0384.86138.0880.23
2012100.1769.89108.0066.27
201379.2552.7383.5754.84
201476.6353.0683.4254.38
201572.0950.8681.3550.53
201667.6646.3977.0946.02
201769.9646.8178.8546.78
201869.3145.4176.0346.32
201972.8148.0876.3849.83
202050.1630.0652.6631.07
202145.1125.8844.8428.90
AAPC[%,（95% CI）]-7.77（-9.93～-5.56）-9.04（-11.38～-6.64）-8.02（-10.25～-5.74）-8.04（-10.13～-5.89）
P值<0.001<0.001<0.001<0.001
年份东部中部西部总体
2010104.9491.97133.24107.37
201193.2286.76143.25102.15
201279.5569.78108.4883.06
201363.1958.1775.6564.50
201459.5958.4478.8863.69
201558.4952.6074.2660.54
201654.3149.7966.9355.94
201753.7051.7572.2957.17
201855.5247.5570.2156.15
201959.6350.2571.0859.27
202036.8435.3147.9239.00
202135.9726.1142.9834.46
AAPC[%,（95% CI）]-7.79（-10.05～-5.47）-8.58（-10.79～-6.32）-8.69（-11.22～-6.09）-8.25（-10.44～-6.01）
P值<0.001<0.001<0.001<0.001
), ArticleFig(id=1322609130255270460, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=CN, label=表2, caption=

2010—2021年中国≥60岁人群LRIs死亡分性别、年龄、地区SMR变化趋势（/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男性女性城市农村
2010128.6091.82134.8986.32
2011127.0384.86138.0880.23
2012100.1769.89108.0066.27
201379.2552.7383.5754.84
201476.6353.0683.4254.38
201572.0950.8681.3550.53
201667.6646.3977.0946.02
201769.9646.8178.8546.78
201869.3145.4176.0346.32
201972.8148.0876.3849.83
202050.1630.0652.6631.07
202145.1125.8844.8428.90
AAPC[%,（95% CI）]-7.77（-9.93～-5.56）-9.04（-11.38～-6.64）-8.02（-10.25～-5.74）-8.04（-10.13～-5.89）
P值<0.001<0.001<0.001<0.001
年份东部中部西部总体
2010104.9491.97133.24107.37
201193.2286.76143.25102.15
201279.5569.78108.4883.06
201363.1958.1775.6564.50
201459.5958.4478.8863.69
201558.4952.6074.2660.54
201654.3149.7966.9355.94
201753.7051.7572.2957.17
201855.5247.5570.2156.15
201959.6350.2571.0859.27
202036.8435.3147.9239.00
202135.9726.1142.9834.46
AAPC[%,（95% CI）]-7.79（-10.05～-5.47）-8.58（-10.79～-6.32）-8.69（-11.22～-6.09）-8.25（-10.44～-6.01）
P值<0.001<0.001<0.001<0.001
), ArticleFig(id=1322609130343350845, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=EN, label=Table 3, caption=

Temporal trends in SMR for LRIs among population aged ≥60 years in China, 2010-2021

, figureFileSmall=null, figureFileBig=null, tableContent=
标化死亡率时期（年）APC[%,（95% CI）]t值P值
总体2010—2013-17.03（-23.64~-9.86）-6.2500.003
2013—2019-3.04（-6.57~0.63）-2.3080.082
2019—2021-22.05（-33.97~-7.99）-4.1700.014
男2010—2014-14.46（-21.04~-7.32）-5.4120.006
2014—2019-1.18（-8.79~7.06）-0.4130.701
2019—2021-20.49（-38.28~2.42）-2.5140.066
女2010—2013-17.55（-22.84~-11.91）-8.0930.001
2013—2019-3.45（-6.26~-0.54）-3.2880.030
2019—2021-25.20（-34.48~-14.61）-6.0870.004
城市2010—2013-16.16（-25.10~-6.15）-4.3410.012
2013—2019-2.76（-7.54~2.26）-1.5430.198
2019—2021-23.16（-38.67~-3.73）-3.2440.032
农村2010—2021-8.04（-10.13~-5.89）-8.105<0.001
东部2010—2014-14.25（-18.31~-9.99）-8.808<0.001
2014—2019-1.10（-5.78~3.81）-0.6320.562
2019—2021-21.56（-32.70~-8.56）-4.3990.012
中部2010—2013-15.35（-23.08~-6.84）-4.8290.008
2013—2019-3.34（-7.40~0.89）-2.2030.092
2019—2021-25.93（-38.84~-10.28）-4.3480.012
西部2010—2021-8.69（-11.22~-6.09）-7.210<0.001
), ArticleFig(id=1322609130418848318, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=CN, label=表3, caption=

2010—2021年中国≥60岁人群LRIs死亡SMR阶段变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
标化死亡率时期（年）APC[%,（95% CI）]t值P值
总体2010—2013-17.03（-23.64~-9.86）-6.2500.003
2013—2019-3.04（-6.57~0.63）-2.3080.082
2019—2021-22.05（-33.97~-7.99）-4.1700.014
男2010—2014-14.46（-21.04~-7.32）-5.4120.006
2014—2019-1.18（-8.79~7.06）-0.4130.701
2019—2021-20.49（-38.28~2.42）-2.5140.066
女2010—2013-17.55（-22.84~-11.91）-8.0930.001
2013—2019-3.45（-6.26~-0.54）-3.2880.030
2019—2021-25.20（-34.48~-14.61）-6.0870.004
城市2010—2013-16.16（-25.10~-6.15）-4.3410.012
2013—2019-2.76（-7.54~2.26）-1.5430.198
2019—2021-23.16（-38.67~-3.73）-3.2440.032
农村2010—2021-8.04（-10.13~-5.89）-8.105<0.001
东部2010—2014-14.25（-18.31~-9.99）-8.808<0.001
2014—2019-1.10（-5.78~3.81）-0.6320.562
2019—2021-21.56（-32.70~-8.56）-4.3990.012
中部2010—2013-15.35（-23.08~-6.84）-4.8290.008
2013—2019-3.34（-7.40~0.89）-2.2030.092
2019—2021-25.93（-38.84~-10.28）-4.3480.012
西部2010—2021-8.69（-11.22~-6.09）-7.210<0.001
), ArticleFig(id=1322609130574037567, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=EN, label=Table 4, caption=

Trends in LRIs mortality rates by age groups among population aged ≥60 years in China 2010—2021（per 100 000）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份60~64岁65~69岁70~74岁75~79岁80~84岁≥85岁
20106.6613.8337.2984.35272.631 473.28
20117.6114.8838.6088.09263.471 337.46
20127.9016.8940.02102.06265.73825.24
20137.4915.8434.8777.23202.01613.30
20147.8915.5835.9677.96187.68610.77
20156.9414.5131.3567.79180.89614.16
20167.8314.2027.4858.39159.53585.48
20177.8914.6928.4157.51163.46602.89
20188.7415.1628.2255.48154.41593.11
20197.4613.1828.5364.86156.61651.73
20206.2610.8921.8745.68110.32370.85
20215.109.4218.6841.8196.27332.46
AAPC[%,（95% CI）]-1.46（-3.96~1.11）-3.16（-5.36~-0.91）-5.76（-7.39~-4.11）-6.60（-8.55~-4.60）-8.33（-9.98~-6.65）-9.90（-13.55~-6.11）
P值0.2320.011<0.001<0.001<0.001<0.001
), ArticleFig(id=1322609130666312256, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322609121380123158, language=CN, label=表4, caption=

2010—2021年中国≥60岁人群分年龄组LRIs死亡率变化趋势（/10万）

, figureFileSmall=null, figureFileBig=null, tableContent=
年份60~64岁65~69岁70~74岁75~79岁80~84岁≥85岁
20106.6613.8337.2984.35272.631 473.28
20117.6114.8838.6088.09263.471 337.46
20127.9016.8940.02102.06265.73825.24
20137.4915.8434.8777.23202.01613.30
20147.8915.5835.9677.96187.68610.77
20156.9414.5131.3567.79180.89614.16
20167.8314.2027.4858.39159.53585.48
20177.8914.6928.4157.51163.46602.89
20188.7415.1628.2255.48154.41593.11
20197.4613.1828.5364.86156.61651.73
20206.2610.8921.8745.68110.32370.85
20215.109.4218.6841.8196.27332.46
AAPC[%,（95% CI）]-1.46（-3.96~1.11）-3.16（-5.36~-0.91）-5.76（-7.39~-4.11）-6.60（-8.55~-4.60）-8.33（-9.98~-6.65）-9.90（-13.55~-6.11）
P值0.2320.011<0.001<0.001<0.001<0.001
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2010—2021年中国≥60岁人群下呼吸道感染死亡流行特征及变化趋势
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丁旭 1, 2 , 李杨 1
现代预防医学 | 疾病预防控制 2025,52(22): 4188-4193
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现代预防医学 |疾病预防控制 2025 , 52 (22) : 4188 -4193
2010—2021年中国≥60岁人群下呼吸道感染死亡流行特征及变化趋势
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2.中华预防医学会第二期公共卫生青年精英高级研修项目, bio={"content":"

丁旭（1993—），男，硕士，医师，研究方向：疾病预防与控制

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丁旭（1993—），男，硕士，医师，研究方向：疾病预防与控制

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丁旭1, 2, 李杨1
作者信息
  • 1.贵州省疾病预防控制中心地方病防治研究所，贵州　贵阳　550004
  • 2.中华预防医学会第二期公共卫生青年精英高级研修项目
通讯作者:
李杨，E-mail：
作者简介:

丁旭（1993—），男，硕士，医师，研究方向：疾病预防与控制

Epidemiological characteristics and temporal trends of lower respiratory infections mortality among the population aged ≥60 years, China, 2010-2021
Xu DING1, 2, Yang LI1
Affiliations
  • Institute for Endemic Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou 550004, China
出版时间: 2025-11-25 doi: 10.20043/j.cnki.MPM.202506398
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摘要
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目的

分析2010—2021年中国60岁及以上人群下呼吸道感染（Lower Respiratory Infections, LRIs）死亡流行特征及变化趋势，为制定和优化防控措施，降低LRIs死亡提供参考依据。

方法

在《全国疾病监测系统死因监测数据集（2010—2012）》和《中国死因监测数据集（2013—2021）》分性别、城乡、地区及年龄收集≥60岁人群LRIs死亡数据，以2010年全国人口普查数据进行标化，分析死亡率和标化死亡率描述LRIs的死亡状况，采用Joinpoint 5.4.0.0软件计算年度变化百分比（Annual Percent Change，APC）和平均年度变化百分比（Average Annual Percent Change，AAPC）分析变化趋势，组间死亡率比较采用χ2检验。

结果

2010—2021年我国监测≥60岁人群LRIs死亡255 385人，占全人群LRIs死亡的87.65%，总体死亡率为57.45/10万，男性（63.07/10万）死亡率高于女性（52.15/10万），城市（77.95/10万）死亡率高于农村（47.04/10万），西部（66.10/10万）地区死亡率高于东部（59.83/10万）和中部（48.17/10万）地区（均P<0.001）。2010—2021年我国≥60岁人群LRIs标化死亡率总体呈下降趋势（AAPC=-8.25%，P<0.001），男性（AAPC=-7.77%，P<0.001）、女性（AAPC=-9.04%，P<0.001）、城市（AAPC=-8.02%，P<0.001）、东部（AAPC=-7.79%，P<0.001）和中部（AAPC=-8.58%，P<0.001）地区标化死亡率阶段变化趋势与总体基本一致，农村（AAPC=APC=-8.04%，P<0.001）和西部（AAPC=APC=-8.09%，P<0.001）地区LRIs标化死亡率稳定下降。在≥60岁人群中，随年龄的增长，LRIs死亡率显著升高，下降幅度呈递增趋势，在65~69岁、70~74岁、75~79岁、80~84岁、≥85岁年龄组中AAPC分别为-3.16%、-5.76%、-6.60%、-8.33%、-9.90%（均P<0.05）。

结论

2010—2021年我国60岁及以上人群LRIs死亡率呈下降趋势，LRIs死亡率随年龄的增长而升高，存在显著的性别、年龄、城乡及地区差异，城市和西部地区男性高龄人群是LRIs死亡高危人群，需给予重点关注和控制。

下呼吸道感染  /  老年人  /  死亡率  /  变化趋势
Objective

To analyze the epidemiological characteristics and temporal trends in Lower Respiratory Infections（LRIs）mortality among population aged ≥60 years in China from 2010 to 2021, providing evidence for formulating and optimizing prevention and control strategies to reduce LRIs-related deaths.

Methods

LRIs mortality data for population ≥60 years were collected from the National Disease Surveillance System Cause of Death Surveillance Dataset（2010-2012）and the Chinese Cause of Death Surveillance Dataset（2013-2021）by sex, urban-rural residence, region, and age group. Mortality rates were standardized using the 2010 National Population Census data. Crude and age-standardized mortality rates were calculated to describe the mortality status of LRIs. Joinpoint 5.4.0.0 software was used to calculate the annual percent change（APC）and average annual percent change（AAPC）to analyze the temporal trends, and the chi-squared test was applied to compare mortality rates across groups.

Results

From 2010 to 2021, a total of 255 385 LRIs deaths occurred among the monitored population aged ≥60 years in China, accounting for 87.65% of all LRIs deaths. The overall crude mortality rate was 57.45 per 100 000 population, with males（63.07/100 000）having a significantly higher mortality rate than females（52.15/100 000）, urban areas（77.95/100 000）higher than rural areas（47.04/100 000）, and the western region（66.10/100 000）higher than the eastern（59.83/100 000）and central（48.17/100 000）regions（all P<0.001）. The age-standardized mortality rate for LRIs among population aged ≥60 years showed an overall downward trend from 2010 to 2020（AAPC=-8.25%, P<0.001）. Similar trends were observed in males（AAPC=-7.77%, P<0.001）, females（AAPC=-9.04%, P<0.001）, urban areas（AAPC=-8.02%, P<0.001）, the eastern region（AAPC =-7.79%, P<0.001）, and the central region（AAPC=-8.58%, P<0.001）, while rural（AAPC=-8.04%, P<0.001）and western regions（AAPC=-8.09%, P<0.001）exhibited steady declines. Among the population aged ≥60 years, LRIs mortality increased significantly with age, while the magnitude of decline showed an upward trend. The AAPCs for the age groups 65-69, 70-74, 75-79, 80-84, and ≥85 years were -3.16%, -5.76%, -6.60%, -8.33%, and -9.90%, respectively（all P<0.05）.

Conclusion

From 2010 to 2021, the mortality rate of LRIs among population aged ≥60 years in China showed a downward trend, which increased significantly with age and showed marked disparities by sex, age, urban/rural residence, and geographic region.The elderly males in urban and western regions are high-risk groups for LRIs-related deaths and require focused attention and targeted control measures.

Lower respiratory infections  /  Aged ≥60 years  /  Mortality  /  Temporal trends
丁旭, 李杨. 2010—2021年中国≥60岁人群下呼吸道感染死亡流行特征及变化趋势. 现代预防医学, 2025 , 52 (22) : 4188 -4193 . DOI: 10.20043/j.cnki.MPM.202506398
Xu DING, Yang LI. Epidemiological characteristics and temporal trends of lower respiratory infections mortality among the population aged ≥60 years, China, 2010-2021[J]. Modern Preventive Medicine, 2025 , 52 (22) : 4188 -4193 . DOI: 10.20043/j.cnki.MPM.202506398
正文
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下呼吸道感染（Lower Respiratory Infections, LRIs）是由细菌、真菌、病毒、支原体、衣原体等病原体感染人体气管、支气管、肺组织所引起的炎症性疾病，危害可从急性症状到多器官衰竭、死亡等[1-2]，尤其在5岁以下儿童和老年人群中，是感染和死亡的高危人群[3]，其疾病负担已成为全球社会面临的重要公共卫生挑战。在我国随着人口老龄化进程加剧，2019年中国70岁及以上老年人因LRIs死亡人数占全球同龄死亡病例的12.59%[2,4]，在2021年该人群死人数较1990年增长75.08%[4-5]，LRIs的疾病负担日益突出。现有研究多聚焦于全人群或儿童群体，针对老年人群的长期死亡趋势分析仍不足。本研究基于全国死因监测数据分析≥60岁老年人LRIs死亡的时空变化规律及人群分布特征，以期为优化老年人LRIs防控策略提供循证依据。
1　资料与方法
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1.1　资料来源
研究数据来源于中国疾病预防控制中心慢性非传染病预防控制中心发布的死因监测分析报告（https://ncncd.chinacdc.cn/jcysj/siyinjcx/syfxbg/），在2012年及以前命名为《全国疾病监测系统死因监测数据集》，2013年起更名为《中国死因监测数据集》。该数据由中国疾控中心依据分层整群随机抽样在全国选取样本监测点获得，目前已覆盖全国人口的24%，涵盖监测人口约3亿，在每年进行数据分析和形成结果之前均对数据进行质量评价，监测资料具有较高可信度。本研究根据《疾病和有关健康问题的国际统计分类》第10次修订本分性别、城乡、地区（东/中/西部）及年龄组（60~64岁、65~69岁、70~74岁、75~79岁、80~84岁、≥85岁）提取≥60岁老年人LRIs（ICD-10编码：A48.1、A70、B96.0-B96.1、B97.21、B97.4-B97.6、J09-J18.2、J18.8-J18.9、J19.6-J22.9、J85.1、J91.0、P23-P23.9、U04-U04.9、Z25.1）死亡率（m）。
1.2　分析指标
采用2010 年全国第六次人口普查 60 岁及以上分年龄组人口数为标准人口（https://www.stats.gov.cn/sj/pcsj/rkpc/6rp/indexch.htm），以直接标准化方法分性别、城乡、地区（东/中/西部）估算各年度≥60岁人群LRIs标化死亡率（Standardized Mortality Ratio，SMR）。其中g为分组，i为年龄组，N为标准人口数。
1.3　Joinpoint回归分析
采用Joinpoint 5.4.0.0软件拟合2010—2021年中国不同性别、城乡、地区及≥60岁人群死亡率及年龄标化率，以对数线性模型确定Joinpoint连接点位置，拟合各阶段年度变化百分比（Annual Percent Change，APC）和平均年度变化百分比（Average Annual Percent Change，AAPC）及其置信区间（95% CI），若APC>0表示死亡率在某阶段呈上升趋势，APC<0表示呈下降趋势，若不存在趋势转折点，APC=AAPC表示在死亡率在研究时间段内单调上升或下降。
1.4　统计学分析
采用Excel 2016 软件分类整理数据并绘制图表，不同组别间死亡率差异使用SPSS 22.0软件 Pearson卡方（χ2）检验进行比较，检验水准α=0.05，双侧检验。
2　结果
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2.1　2010—2021年中国≥60岁人群LRIs死亡概况
2010—2021年我国监测≥60岁人群因LRIs死亡255 385人，占全人群LRIs死亡的87.65%，其中≥70岁人群死亡占79.07%，总体死亡率为57.45/10万。在不同性别（χ2=2 305.976，P<0.001）、城乡（χ2=16 516.252，P<0.001）、地区（χ2=3 832.107，P<0.001）及年龄组（χ2=1 070 319.78，P<0.001）间LRIs死亡率差异均具有统计学意义，男性（63.07/10万）死亡率高于女性（52.15/10万），城市（77.95/10万）死亡率高于农村（47.04/10万），西部（66.10/10万）地区死亡率高于东部（59.83/10万）和中部（48.17/10万）地区，且随着年龄的增长，LRIs死亡率逐渐上升，在≥85岁人群中年均死亡率最高为559.34/10万。见表1。
2.2　2010—2021年中国≥60岁人群不同性别LRIs死亡趋势
2010—2021年我国≥60岁人群LRIs男性各年龄段死亡率均高于女性，男性标化死亡率高于女性且均呈现下降趋势，分别从2010年的128.60/10万、91.82/10万下降至2021年的45.11/10万、25.88/10万，在各阶段女性LRIs标化死亡率变化趋势均有统计学意义（均P<0.05），其中女性下降趋势较男性快，AAPC分别为-9.04%和-7.77%（均P<0.001）。见图1、表2和表3。
2.3　2010—2021年中国≥60岁人群不同地区LRIs死亡趋势
2010—2021年我国≥60岁人群LRIs标化死亡率呈现明显的地区差异，城市（AAPC=-8.02%，P<0.001）、农村（AAPC=-8.04%，P<0.001）、东部（AAPC=-7.79%，P<0.001）、中部（AAPC=-8.58%，P<0.001）及西部（AAPC=-8.69%，P<0.001）地区SMR均呈下降趋势，各年城市地区SMR均高于农村，西部地区均高于东部和中部地区。在农村和西部地区≥60岁人群LRIs标化死亡率呈稳定下降趋势（APC=AAPC），城市（APC=-23.16%，P=0.032）、中部（APC=-25.93%，P=0.012）及东部（APC=-21.56%，P=0.012）地区SMR在2019—2021年降幅较快。见表2和表3。
2.4　2010—2021年中国≥60岁人群不同年龄组LRIs死亡趋势
2010—2021 年我国≥60岁人群LRIs标化死亡率总体呈下降趋势（AAPC=-8.25%，P<0.001），由2010 年107.37/10万下降至2021年34.46/10万。在不同年龄组人群中LRIs死亡率呈现显著的年龄差异，≥85岁人群死亡率始终较高，60~64岁年龄组维持在较低水平，变化趋势不显著（AAPC=-1.46%，P=0.232），而随着年龄的增长，LRIs死亡率显著上升，下降幅度逐渐增大，在65~69岁、70~74岁、75~79岁、80~84岁、≥85岁年龄组中AAPC分别为-3.16%、-5.76%、-6.60%、-8.33%、-9.90%，变化趋势均有统计学意义（均P<0.05）。见图1、表2和表4。
3　讨论
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LRIs是全球老龄化社会面临的重大公共卫生挑战，近年来随着全球老龄化进程加速，LRIs死亡人数逐渐上升，依然为全球主要致死性疾病[6]，在发展中国家尤为突出。2010—2021 年中国≥60岁人群LRIs死亡率为57.45/10万，占全人群 LRIs 死亡的 87.65%，其中≥70岁人群死亡占79.07%，显著高于全球70岁及以上人群LRIs死亡占比（约49%）[2]，在我国LRIs疾病负担较全球高度集中，老年群体的健康威胁日益凸显。
2010—2021年间，我国≥60岁人群 LRIs 死亡率呈现出显著的性别差异与下降趋势，男性（63.07/10万）较女性（52.15/10万）高出约21%，与全球老年人感染性疾病性别分布特征一致[2]，在男性群体中更普遍存在吸烟、饮酒及职业暴露等风险行为[2,7]，增加呼吸道黏膜损伤及感染风险。相较于男性，女性因LRIs死亡下降速度更快，各阶段女性死亡率变化趋势均具统计学意义，在针对老年女性实施的公共卫生干预措施取得更为显著的成效[8]。
我国老年人群LRIs死亡率总体呈明显下降趋势，尤其自2010年以来，我国不断加强空气污染治理，空气中细颗粒物等污染物持续改善，在降低LRIs死亡风险方面发挥了积极作用[2,9-10]。随着国家基本公共卫生服务项目的广泛普及，老年人定期健康体检和个性化健康指导，显著提升了疾病的早期筛查与干预能力[11]，驱动LRIs死亡快速下降。2013—2019年间，LRIs死亡率下降趋势明显放缓，在农村与西部地区得益于疫苗普及、健康宣教等长期基础干预[7,12]，LRIs死亡呈线性下降趋势，但城市和西部地区始终为高风险区域，与农村及东中部地区形成梯度差异。2019年以来受新冠非药物干预措施影响[13-15]，减少LRIs病原传播，在短期内老年人群死亡显著下降（APC<-20%），但仍面临后疫情时期LRIs死亡上升风险。
LRIs死亡具有显著的年龄差异特征，在我国老年人群中随年龄增长呈指数级上升，与全球LRIs死亡流行特征一致[2]。相较于60~64岁人群，在≥85岁人群中LRIs年均死亡率上升约50倍，凸显高龄阶段的健康脆弱性。值得关注的是，LRIs死亡率下降幅度随年龄增长呈递增趋势，在持续优化保障高龄人群的疫苗接种，将保护脆弱高龄群体与激活年轻老年群体健康管理相结合，加强养老机构和居家医养结合的感染防控能力，实施精准管理进一步降低LRIs死亡率，将在提升人均期望寿命发挥重要作用[16]。
本研究基于我国死因监测数据集分析了自2010年以来≥60岁人群LRIs死亡趋势，相较以往学者利用全球疾病负担（Global Burden of Disease，GBD）数据库，更能实际反映我国LRIs的疾病负担及变化趋势，可为优化防控策略、评估防治效果提供参考依据。本研究也存在一定局限性，如缺乏LRIs病原体分析及耐药性监测，未能量化LRIs的主要病因，难以精准指导疾病预防与抗菌药物选择，以及城乡划分差异等可能会影响结果对比。在快速老龄化的背景下，仍需开展老年人群LRIs多病原监测，结合卫生经济学评估量化不同防控措施的成本效益，为政策调整提供科学依据。
综上所述，2010—2021年我国≥60岁人群LRIs死亡在不同维度存在差异且呈下降趋势，在西部和城市地区、男性、高龄人群中死亡率依然较高，LRIs随年龄增长死亡风险越高，高龄人群的死亡率下降幅度更明显。今后应聚焦不同性别、地区、年龄组特点，采取差异化防控策略，加强城市空气污染治理，改善西部地区医疗资源配置，提高高龄老人健康管理水平，持续降低LRIs对老年人群的健康危害。

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doi: 10.20043/j.cnki.MPM.202506398
  • 接收时间：2025-06-24
  • 首发时间：2026-10-29
  • 出版时间：2025-11-25
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  • 收稿日期：2025-06-24
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    1.贵州省疾病预防控制中心地方病防治研究所，贵州　贵阳　550004
    2.中华预防医学会第二期公共卫生青年精英高级研修项目

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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