1990―2019年我国肌肉骨骼疾病负担分析  

Disease burden of musculoskeletal disorders in China from 1990 to 2019

作　　者：吴惠一 袁琴 张洋 兰亚佳[2] WU Huiyi;YUAN Qin;ZHANG Yang;LAN Yajia(Department of Epidemiology and Biostatistics,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Department of Occupational and Environmental Health,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Chinese Evidence based Medicine Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西公共卫生学院,四川大学华西第四医院流行病与卫生统计学系,成都610041 [2]四川大学华西公共卫生学院,四川大学华西第四医院劳动卫生与环境卫生学系,成都610041 [3]四川大学华西医院中国循证医学中心,成都610041

出　　处：《中华疾病控制杂志》2023年第6期655-661,共7页Chinese Journal of Disease Control & Prevention

基　　金：四川省科技计划项目(2022YFS0422)。

摘　　要：目的分析1990-2019年我国肌肉骨骼疾病负担变化情况。方法基于全球健康数据交换库(Global Health Data Exchange,GHDx),利用发病率、患病率和伤残调整寿命年(disability adjusted life year,DALY)等指标评价类风湿性关节炎、骨关节炎、腰痛、颈痛和痛风等肌肉骨骼疾病负担,利用Joinpoint回归模型计算平均年度变化百分比(average annual percentage change,AAPC),分析肌肉骨骼疾病负担变化趋势。结果2019年我国肌肉骨骼疾病标化发病率和DALY率分别为3764.99/10万和1585.44/10万,较1990年分别下降17.80%和6.05%。除痛风外,女性各类肌肉骨骼疾病的标化发病率和DALY率均高于男性。1990-2019年肌肉骨骼疾病标化发病率和DALY率总体呈下降趋势,AAPC分别为-0.68%和-0.22%,其中腰痛下降最明显而痛风呈较明显的上升趋势。骨关节炎、腰痛和痛风可归因于高BMI的疾病负担持续增加,腰痛可归因于吸烟和职业工效学因素的疾病负担下降,痛风可归因于肾功能损伤的疾病负担上升。结论1990-2019年我国肌肉骨骼疾病负担总体呈下降趋势,主要是由于腰痛的疾病负担明显下降,类风湿性关节炎、骨关节炎、颈痛和痛风等疾病的防控形势依然严峻。Objective To analyze the past temporal trends of musculoskeletal disorders in China from 1990 to 2019.Methods Incidence,prevalence and disability adjusted life year(DALY)data for musculoskeletal disorders,including rheumatoid arthritis,osteoarthritis,low back pain,neck pain,and gout,were retrieved from the Global Health Data Exchange(GHDx),to evaluate the disease burden.The joinpoint regression model was utilized to analyze the trend of these disorders from 1990 to 2019,with the trends measured using the average annual percentage change(AAPC).Results In 2019,the age-standardized incidence rate for musculoskeletal disorders in China was 3764.99/100000 and the DALY rate was 1585.44/100000.These rates decreased by 17.80%and 6.05%,respectively,compared with 1990.The age-standardized rates of incidence and DALY for all musculoskeletal disorder categories were higher in women,except for gout.From 1990 to 2019,the age-standardized rates of incidence and DALY were decreased for total musculoskeletal disorders,with AAPCs of-0.68%and-0.22%,respectively.The rates for low back pain exhibited a significant decrease,but those for gout markedly increased.The disease burden attributable to high body mass index(BMI)for osteoarthritis,low back pain,and gout demonstrated a declining trend.However,the burden attributed to smoking and occupational ergonomic factors for low back pain decreased,while that attributed to impaired kidney function for gout increased.Conclusions From 1990 to 2019,the overall disease burden of musculoskeletal disorders in China has decreased,primarily due to the decline in low back pain.Nevertheless,the burden caused by other musculoskeletal conditions,such as rheumatoid arthritis,osteoarthritis,neck pain,and gout,remains a significant public health challenge.

关 键 词：肌肉骨骼疾病 发病率 疾病负担 危险因素 

分 类 号：R181.3[医药卫生—流行病学]