《中国心血管健康与疾病报告2022》要点解读

doi:10.12114/j.issn.1007-9572.2023.0408

摘要/Abstract

摘要： 由于中国人口老龄化进程的加速以及不健康生活方式的流行，存在心血管病（CVD）危险因素的人群巨大，中国CVD负担持续加重。在我国城乡居民疾病死亡构成比中，CVD仍居首位。2020年，农村、城市CVD分别占死因的48.00%和45.86%，每5例死亡中就有2例死于CVD。推算我国CVD现患人数3.3亿，其中脑卒中1 300万，冠心病1 139万，心力衰竭890万，肺源性心脏病500万，心房颤动487万，风湿性心脏病250万，先天性心脏病200万，外周动脉疾病4 530万，高血压2.45亿。2020年中国心脑血管疾病的住院总费用合计为2 709.01亿元。CVD防治工作仍然任重道远。总的来说，我国应从"已病"和"未病"双重着手，既要做好CVD的二级预防治疗，还应进一步强化高血压、高血糖、高血脂等可调节危险因素的上游治疗，并注重卫生保健和公共卫生资源的分配和优先次序，以期更早地迎来CVD防治拐点。

关键词: 心血管疾病, 流行病学, 健康影响因素, 危险因素, 患病率, 死亡率, 社区防治, 康复, 基础研究, 器械研发, 费用，医疗

Abstract:

Due to the acceleration of population aging and the prevalence of unhealthy lifestyles, the huge population with cardiovascular disease (CVD) risk factors, the burden of CVD continues to increase in China. CVD is still the leading cause of death among urban and rural residents in China. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively, and two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is 330 million, including 13 million cases of stroke, 11.39 million cases of coronary heart disease, 8.9 million cases of heart failure, 5 million cases of pulmonary heart disease, 4.87 million cases of atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of peripheral artery disease, and 245 million cases of hypertension. The total hospitalization costs were 270.901 billion yuan for CVD in China in 2020. The prevention and treatment of CVD in China still has a long way to go. In general, we should not only do a good job in secondary prevention and treatment of CVD, but also further strengthen the upstream treatment of modifiable risk factors such as hypertension, hyperglycemia and hyperlipidemia starting with both preventive treatment and treatment diseases. In addition, attention should be paid to the allocation and prioritization of health care and public health resources, so as to reach the inflection point of CVD prevention and treatment as early as possible.

Key words: Cardiovascular disease, Epidemiology, Health influencing factors, Risk factors, Prevalence, Mortality, Community-based prevention and control, Rehabilitation, Basic research, Medical device development, Fees, medical

马丽媛,王增武,樊静,等. 《中国心血管健康与疾病报告2022》要点解读[J]. 中国全科医学, 2023, 26(32): 3975-3994. DOI: 10.12114/j.issn.1007-9572.2023.0408.
MA Liyuan,WANG Zengwu,FAN Jing, et al. Interpretation of Report on Cardiovascular Health and Diseases in China 2022[J]. Chinese General Practice, 2023, 26(32): 3975-3994. DOI: 10.12114/j.issn.1007-9572.2023.0408.

图/表 21

图1 2018年中国≥15岁吸烟人群中过去12个月内尝试戒烟的主要原因

Figure 1 The main reasons for smoking quit attempt among Chinese residents aged ≥15 years in the past 12 months in 2018

图2 1982—2015年中国居民碳水化合物、蛋白质和脂肪供能比变化趋势

Figure 2 Trends in the ratio of carbohydrates，proteins and fats for energy supply in Chinese residents from 1982 to 2015

图3 1982—2015年中国居民食用油、烹调用盐摄入量变化情况

Figure 3 Changes in consumption of cooking oil and salt among Chinese residents from 1982 to 2015

图4 1985—2014年中国汉族中学生体质健康达标优秀率

Figure 4 Prevalence of excellent health status and physical fitness among Chinese Han students in middle schools from 1985 to 2014

图5 2002—2017年中国居民超重率和肥胖率变化状况

Figure 5 Changes in the prevalence of overweight and obesity among Chinese residents between 2002 and 2017

图6 1991—2015年中国高血压知晓率、治疗率和控制率

Figure 6 Awareness，treatment and control rates of hypertension in Chinese adults aged ≥18 years from 1991 to 2015

图7 中国成人不同血脂异常类型患病率注：CCDRFS=中国慢性病及危险因素监测，CANCDS=中国成人营养与慢性病监测，China-PEACE MPP=中国心血管病高危人群早期筛查与综合干预百万人群，CNSSPP=中国脑卒中筛查与预防项目，TC=总胆固醇，LDL-C=低密度脂蛋白胆固醇，HDL-C=高密度脂蛋白胆固醇，TG=三酰甘油。

Figure 7 Prevalence of different types of dyslipidemia among Chinese adults

图8 1980—2017年中国糖尿病患病率调查注：2002年为城市人群糖尿病患病率。

Figure 8 Surveys of diabetes prevalence in China from 1980 to 2017

图9 2020年中国农村和城市居民主要疾病死因构成比注：由于数据修约，部分构成比之和非100.00%。

Figure 9 Proportion of major causes of death among rural and urban Chinese residents in 2020

图10 2000—2020年中国城乡居民心血管病死亡率变化

Figure 10 Changes in cardiovascular mortalities in urban and rural Chinese residents from 2000 to 2020

图11 2002—2020年中国城乡地区冠心病死亡率变化趋势

Figure 11 Changes in coronary heart diseases mortalities in urban and rural Chinese residents from 2002 to 2020

图12 2002—2020年中国城乡地区急性心肌梗死死亡率变化趋势

Figure 12 Trends of acute myocardial infarction mortalities in urban and rural Chinese residents from 2002 to 2020

图13 2009—2021年中国大陆地区PCI手术量注：PCI=经皮冠状动脉介入术。

Figure 13 Number of PCI treatment cases from 2009 to 2021 in China

图14 2003—2020年中国城乡居民脑血管病粗死亡率变化趋势

Figure 14 Trends of crude mortalities of cerebrovascular diseases in urban and rural Chinese residents from 2003 to 2020

图15 2009—2021年中国导管射频消融手术量

Figure 15 Number of radiofrequency catheter ablation cases in China from 2009 to 2021

图16 2013—2020年中国大陆先天性心脏病介入手术量

Figure 16 Interventional treatment volume of congenital heart disease in China from 2013 to 2020

图17 中国历年第一单位和通信作者单位发表的心血管基础研究论文数量

Figure 17 Basic research articles on cardiovascular diseases published by the first and corresponding author from institutions in China

图18 1980—2020年中国心血管病患者出院人次数变化趋势注：心血管病包括缺血性心脏病（心绞痛、急性心肌梗死及其他缺血性心脏病，2002年前卫生统计年报中为冠心病）、慢性风湿性心脏病、急性风湿热、肺栓塞、心律失常、心力衰竭、高血压（包括高血压心脏病和肾脏病）；脑血管病包括脑出血和脑梗死。

Figure 18 Trends in the number of discharged cardiovascular diseases patients in China from 1980 to 2020

图19 1980—2020年中国心血管病和糖尿病患者出院人次数变化趋势

Figure 19 Trends in number of discharged patients of cardiovascular diseases and diabetes in China from 1980 to 2020

图20 2004—2020年中国3种主要心血管病住院总费用变化趋势（当年价格）

Figure 20 Trends of the annual total hospitalization costs for the 3 major cardiovascular diseases from 2004 to 2020

图21 2004—2020年中国3种主要心血管病患者次均住院费用变化趋势（当年价格）

Figure 21 Trends in average per-hospitalization costs for 3 major cardiovascular diseases in China from 2004 to 2020

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