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for the development of measures to the target of reducing the probability of premature mortality due to these four major NCDs in
the Health China 2030 plan. Methods This analysis was conducted in May 2021 based on data collected from Pudong New
Area's Residents Death Surveillance Database，involving registered residents of Pudong New Area who died of cardiovascular
and cerebrovascular diseases，cancer，diabetes and chronic respiratory disease between 2002-01-01 and 2020-12-31. Crude
mortality，age-standardized mortality and probability of premature mortality were used for analyzing deaths due to the four above-
mentioned NCDs. The annual percent change （APC） was adopted to analyze the temporal trend of mortality and probability of
premature mortality. Results The crude mortality of four major NCDs ascended from 526.82/100 000 in 2002 to 678.84/100 000
in 2020 （APC=1.56%，Z=13.715，P<0.001）. The age-standardized mortality of four major NCDs decreased from 404.05
/100 000 in 2002 to 260.87/100 000 in 2020（APC=-2.09%，Z=-12.428，P<0.001）. The probability of premature mortality
caused by four major NCDs decreased from 13.09% in 2002 to 8.45% in 2020 （APC=-2.31%，Z=-15.847，P<0.001）. The
probability of premature mortality caused by cardiovascular and cerebrovascular diseases was declined from 3.57% in 2002 to 2.38%
in 2020 （APC=-2.21%，Z=-9.739，P<0.001），and that caused by cancer decreased from 8.36% to 5.49%（APC=-2.24%，
Z=-19.476，P<0.001），and that by chronic respiratory disease reduced from 1.08% to 0.24%（APC=-7.23%，Z=-13.326，
P<0.001）. No significant temporal trend for the probability of premature mortality caused by diabetes was found （Z=-0.395，
P=0.698）. The probability of premature mortality caused by four major NCDs in males was higher than that in females. According
to the annual increase rates during 2015 to 2020，it is estimated that the probability of premature mortality caused by these four
major NCDs would be 6.67%. Conclusion The crude mortality of the four major NCDs in Pudong New Area ascended during
2002—2020，and both the age-standardized mortality and the probability of premature mortality showed a downward tendency in
the same period. Pudong New Area had achieved the goal in the Health China 2020 plan of reducing the probability of premature
mortality of four NCDs in 2020. However，according to the present annual increase rates，the task of achieving the Health China
2030 target of the decent of the probability of premature mortality caused by four major NCDs would be daunting. Thus，more
measures should be taken to strengthen the containment of such NCDs. Moreover，males should be treated as the key group，and
more attention should be paid to the premature death caused by diabetes in males.
【Key words】 Chronic disease；Cardiovascular diseases；Cerebrovascular disorders；Neoplasms；Diabetes
mellitus；Signs and symptoms，respiratory；Mortality；Probability of premature mortality；Temporal trend；Shanghai

慢性非传染性疾病（non-communicable disease）是 为研究对象，从浦东新区户籍居民死因数据库中筛选死
继传染病之后，人类健康面对的又一重大威胁，世界卫 亡日期在 2002-01-01 至 2020-12-31 因 4 类主要慢性病
生组织《2020 年世界卫生统计》指出与针对传染病防 （包括心脑血管疾病、恶性肿瘤、糖尿病及慢性呼吸系
控工作所取得的进展相比，针对慢性非传染性疾病所导 统疾病）死亡的数据进行分析。浦东新区死因监测工作
致的过早死亡的防控工作依然进展缓慢 ［1］ 。据估计， 以具有法律效力的死亡证为基础，卫生、公安及民政等
2016 年全球范围内慢性非传染性疾病共计导致 4 100 万 多个部门参与其中。社区卫生服务中心与疾病预防控制
人的死亡，占人群死亡总数的 71%，其中尤以心脑血 中心按月开展浦东新区居民死亡证的收集工作，并对致
管疾病、恶性肿瘤、慢性呼吸系统疾病及糖尿病导致的 死疾病进行疾病编码及死因复核，构建浦东新区户籍居
危害最为严重 ［2］ 。国务院颁布的《“健康中国 2030” 民死因数据库。本研究中人口学资料由浦东新区公安局
规划纲要》中提出，2020 年与 2030 年我国 4 类主要慢 提供。
性病早死概率应在 2015 年的基础上分别下降 10% 与 1.2 方法
30% ［3］ 。浦东新区隶属于上海市，是上海市最大的市 1.2.1 调查方法 采用国际疾病分类第 10 版（The
辖区，也是我国人口老龄化程度最深的地区之一，近年 International Statistical Classification of Diseases and
来随着人均期望寿命的不断增长，慢性非传染性疾病过 Related Health Problems 10th Revision，ICD-10）对居民
早死亡所导致的危害得到了广泛关注 ［4］ 。为了解慢性 死因进行编码及归类，其中心脑血管疾病的编码范围
非传染性疾病对浦东新区居民的危害并为浦东新区及时 为 I00-I99，恶性肿瘤的编码范围为 C00-C97，糖尿病
调整慢性病防控策略实现“健康中国 2030”下降目标 的编码范围为 E10-E14，慢性呼吸系统疾病编码范围为
提供数据参考，现对 2002—2020 年浦东新区居民 4 类 J30-J98。
主要慢性病死亡资料开展分析，结果报告如下。 1.2.2 指标解释 （1）4 类主要慢性病早死概率：死
1 对象与方法 亡概率指存活满某确切年龄 x 岁的人群，在活满（x+n）
1.1 研究对象 2021 年 5 月，将浦东新区户籍居民作 岁之前死亡的概率，常用 % 表示；4 类主要慢性病早