Abstract: Background　Stroke is a disease threatening human health globally.At present，the epidemiological data of stroke mortality among residents in Pudong New Area is absent.Objective　To explore the epidemiological characteristics and the potential years of life lost due to stroke among residents in Pudong New Area of Shanghai from 2002 to 2017，so as to provide a reference for establishing intervention measures.Methods　Records of stroke mortality data of residents in Pudong New Area of Shanghai from 2002 to 2017 were derived from the death surveillance system.Crude mortality among different populations was compared by Z test to Poisson distribution，and standardized mortality was compared by Mantel-Haenszel test.The annual percentage change （APC） of stroke mortality was calculated by Joinpoint 4.0.4.Indicators of life loss included potential years of life loss （PYLL），potential years of life loss rate （PYLLR），average years of life loss （AYLL），standardized potential years of life loss （SPYLL） and standardized potential years of life loss rate （SPYLLR）.The contribution of demographic and non-demographic factors to the change of stroke mortality was assessed by the rate difference decomposition method.Results　The crude mortality and standardized mortality of stroke among residents in Pudong New Area between 2002 and 2017 were 129.85/100 000 and 47.03/100 000，respectively，with 56 180 stroke deaths in total.The crude mortality rate of stroke kept stable （Z=1.362，P=0.195），and the standardized death rate of stroke declined over the years （APC=-3.78%，Z=-14.950，P<0.001）.The crude mortality rate of ischemic stroke increased year by year （APC=3.62%，Z=14.055，P<0.001），and the standardized mortality rate showed a downward trend （APC=-0.74%，Z=4.639，P<0.001）；the crude mortality rate and standardized mortality rate of hemorrhagic stroke decreased year by year （APC=-1.46%，Z=-5.739，P<0.001；APC=-5.43%，Z=-13.409，P<0.001）.The crude mortality rate of stroke in male residents was lower than that in female residents （Z=-5.465，P<0.001），and the standardized death rate was higher than that in female residents （Z=-35.779，P<0.001）.Mortality rates of the children group，the youth group，the middle-aged group，the younger aged group and the older aged group were 0.15/100 000，2.52/100 000，27.86/100 000，248.02/100 000 and 2 019.20/100 000，respectively.The trend analysis of mortality in age groups showed that the mortality of stroke in all age groups showed a downward trend （P<0.001）.PYLL of stroke was 87 302 years，PYLLR was 2.02‰ and AYLL was 1.55 years per person.The mortality rate of stroke in Pudong New Area in 2017 was higher than that in 2002，and demographic factors contributed to the increase of stroke mortality，and non-demographic factors reduced the mortality.Conclusion　The stroke mortality in Pudong New Area keep stable during 2002—2017，which cause heavy burden of disease.As population aging is the major contributor，comprehensive prevention and control measures should be taken.

Key words: Stroke, Mortality, Difference decomposition, Potential years of life lost

摘要： 背景　脑卒中是在全球范围内严重威胁人类健康的一类疾病，上海市浦东新区居民脑卒中死亡流行病学资料目前依然缺乏。目的　了解2002—2017年上海市浦东新区居民脑卒中死亡特征与减寿情况，为制定相应的干预措施提供依据。方法　以上海市浦东新区户籍居民为研究对象，从浦东新区死因监测系统中提取死亡日期为2002—2017年死因为脑卒中死亡居民的资料进行分析。不同人群间粗死亡率比较采用Poisson分布资料Z检验，标化死亡率比较采用Mantel-Haenszel检验。脑卒中死亡率年均变化百分比（APC）采用Joinpoint 4.0.4计算。减寿指标包括潜在减寿年数（PYLL）、潜在减寿率（PYLLR）、平均减寿年数（AYLL）、标化潜在减寿年数（SPYLL）以及标化潜在减寿率（SPYLLR）。人口因素与非人口因素对于脑卒中死亡率变化的贡献采用率差别分解法进行评价。结果　2002—2017年浦东新区累计报告居民脑卒中死亡56 180例，年均粗死亡率为129.85/10万，标化死亡率为47.03/10万。2002—2017年脑卒中粗死亡率保持稳定（Z=1.362，P=0.195）；标化死亡率呈逐年下降趋势（APC=-3.78%，Z=-14.950，P<0.001）；其中缺血性脑卒中粗死亡率呈逐年上升趋势（APC=3.62%，Z=14.055，P<0.001），标化死亡率呈逐年下降趋势（APC=-0.74%，Z=4.639，P<0.001）；出血性脑卒中粗死亡率与标化死亡率均呈逐年下降趋势（APC粗死亡率=-1.46%，Z粗死亡率=-5.739，P粗死亡率<0.001；APC标化死亡率=-5.43%，Z标化死亡率=-13.409，P标化死亡率<0.001）。男性居民脑卒中粗死亡率低于女性（Z=-5.465，P<0.001），标化死亡率高于女性（Z=-35.779，P<0.001）。儿童组、青年组、中年组、低龄老年人组、高龄老年人组年龄别死亡率分别为0.15/10万、2.52/10万、27.86/10万、248.02/10万、2 019.20/10万。年龄别死亡率趋势分析显示，2002—2017年青年组、中年组、低龄老年人组、高龄老年人组居民脑卒中死亡率均呈逐年下降趋势（P<0.001）。脑卒中PYLL为87 302年，PYLLR为2.02‰，AYLL为1.55年/人。2017年浦东新区居民脑卒中死亡率高于2002年，其中人口因素影响死亡率升高，而非人口因素作用使死亡率下降。结论　2002—2017年浦东新区居民脑卒中死亡率保持稳定，导致了严重的疾病负担，人口老龄化因素发挥主要促进作用，应采取综合性的防控措施。

关键词: 脑卒中, 死亡率, 差别分解法, 潜在减寿年数