1990—2019年中国肝硬化疾病负担变化趋势分析OACSTPCD
Changing trend of the disease burden of liver cirrhosis in China from 1990 to 2019
目的 分析1990-2019年中国人群肝硬化流行情况和疾病负担变化趋势,为中国肝硬化防治策略的制定提供数据参考.方法 从2019年全球疾病负担(GBD 2019)收集整理1990-2019年中国肝硬化发病、死亡、伤残调整寿命年(DALY)、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD)等疾病负担数据,使用Joinpoint回归模型分析其疾病负担变化趋势,使用年龄-时期-队列(APC)模型评估年龄、时期和队列效应,使用R软件BAPC包预测未来疾病负担变化情况.结果 与1990年相比,2019年中国总体、男性和女性人群肝硬化发病例数和患病例数均有所上升,而死亡例数有所下降.1990-2019年中国人群肝硬化标化发病率、标化患病率和标化死亡率均呈下降趋势,平均每年分别下降0.62%(95%CI:-0.74%～-0.50%,t= 9.99,P<0.001)、0.44%(95%CI:-0.53%～-0.35%,t=13.18,P<0.001)和3.02%(95%CI:-3.12%～-2.93%,t=7.58,P<0.001).1990—2019年中国人群肝硬化标化DALY率、YLL率和YLD率均呈下降趋势,平均每年分别下降3.27%(95%CI:-3.37%～-3.18%,t=6.22,P<0.001)、3.32%(95%CI:-3.42%～-3.22%,t=9.31,P<0.001)和1.42%(95%CI:-1.49%～-1.34%,t=4.93,P<0.001).1990—2019年中国人群肝硬化发病率随年龄增长呈先上升后下降趋势,死亡率呈上升趋势;发病风险和死亡风险随时间和出生队列推移均呈现下降趋势.预测模型显示,2020-2030年中国肝硬化造成的标化发病率、患病率、死亡率和DALY率均呈下降趋势.男性和女性最主要的危险因素均是酒精,其次是药物.结论 1990-2019年中国肝硬化疾病负担呈下降趋势,且存在性别和年龄差异,中年男性人群是肝硬化疾病负担的重点人群,应采取有效措施进行干预.
Objective To investigate the prevalence of liver cirrhosis and the changing trend of the disease burden of liver cirrhosis in the Chinese population from 1990 to 2019,and to provide a data reference for formulating the prevention and treatment strategies for liver cirrhosis in China.Methods The Global Burden of Disease Study 2019 was used to collect the data on the incidence rate,mortality rate,disability-adjusted life years(DALY),years of life lost(YLL),and years lived with disability(YLD)of liver cirrhosis.The Joinpoint regression model was used to analyze the changing trend of disease burden;the age-period-cohort(APC)model was used to evaluate age,period,and cohort effects;R software BAPC package was used to predict future changes in disease burden.Results From 1990 to 2019 in China,there were increases in the numbers of liver cirrhosis cases and prevalent cases in the general population,as well as in the male and female populations,while there was a reduction in the number of deaths.From 1990 to 2019,the standardized incidence rate,standardized prevalence rate,and standardized mortality rate of liver cirrhosis in the Chinese population showed a downward trend,with a mean annual reduction of 0.62%(95%confidence interval[CI]:-0.74%to-0.50%,t= 9.99,P<0.001),0.44%(95%CI:-0.53%to-0.35%,t=13.18,P<0.001),and 3.02%(95%CI:-3.12%to-2.93%,t=7.58,P<0.001),respectively.From 1990 to 2019,the standardized DALY,YLL,and YLD rates of liver cirrhosis in the Chinese population also showed a downward trend,with a mean annual reduction of 3.27%(95%CI:-3.37%to-3.18%,t=6.22,P<0.001),3.32%(95%CI:-3.42%to-3.22%,t=9.31,P<0.001),and 1.42%(95%CI:-1.49%to-1.34%,t=4.93,P<0.001),respectively.From 1990 to 2019,the incidence rate of liver cirrhosis in the Chinese population first increased and then decreased with age,while the mortality rate showed an increasing trend,and the risks of disease onset and death showed a decreasing trend with time and birth cohort.The predictive model showed that the standardized incidence rate,prevalence rate,mortality rate,and DALY rate of liver cirrhosis in China will show a decreasing trend from 2020 to 2030.Alcohol was the most important risk factor for both male and female populations,followed by medication.Conclusion The disease burden of liver cirrhosis in China shows a decreasing trend from 1990 to 2019,with sex and age differences,especially in the middle-aged male population.Effective measures should be taken for intervention.
刘珊山;于晓辉;秦建伟
中国人民解放军联勤保障部队第九四〇医院消化内科,兰州 730050||甘肃中医药大学第一临床医学院,兰州 730000中国人民解放军联勤保障部队第九四〇医院消化内科,兰州 730050中国人民解放军联勤保障部队第九四〇医院肝胆外科,兰州 730050
肝硬化患病代价预测中国
Liver cirrhosisCost of IllnessForecastingChina
《临床肝胆病杂志》 2024 (004)
726-733 / 8
联勤保障部队第九四〇医院院内课题(2022yxky016);甘肃省非感染性肝病临床医学研究中心(21JR7RA017)Joint Support Force 940 Hospital In-hospital Project(2022yxky016);Gansu Provincial Clinical Medical Research Center for Non infectious Liver Diseases(21JR7RA017)
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