1990—2044年中国丙型病毒性肝炎相关疾病的疾病负担分析及预测  

Analysis and prediction of burden of viral hepatitis C⁃associated diseases in China from 1990 to 2044

作　　者：周梅[1] 姚丽熙 吴银莲[2] 林苏[2] 黄娇凤 ZHOU Mei;YAO Lixi;WU Yinlian;LIN Su;HUANG Jiaofeng(Medical Department,The First Affiliated Hospital,Fujian Medical University,Fuzhou,Fujian 350005,China;Department of Hepatology,The First Affiliated Hospital,Fujian Medical University,Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases,Fuzhou,Fujian 350005,China)

机构地区：[1]福建医科大学附属第一医院医务部,福建福州350005 [2]福建医科大学附属第一医院肝病中心肝内科、福建省肝病与肠道疾病临床医学研究中心,福建福州350005

出　　处：《中国血吸虫病防治杂志》2023年第5期476-485,共10页Chinese Journal of Schistosomiasis Control

基　　金：福建省自然科学基金(2022J01700)。

摘　　要：目的分析1990—2019年我国丙型病毒性肝炎(丙型肝炎)相关疾病的疾病负担变化,并预测2020—2044年变化趋势,为有针对性地制定丙型肝炎防控策略提供依据。方法在2019年全球疾病负担研究(Global Burden of Disease,GBD 2019)数据库中,筛选出1990—2019年我国丙型肝炎相关疾病总疾病负担,分析急性丙型肝炎(acute hepatitis C,AHC)、丙型肝炎相关慢性肝病(chronic liver diseases,CLD)、丙型肝炎相关肝癌年龄标准化患病率、发病率、死亡率及伤残调整寿命年(disability-adjusted life years,DALY)率的变化趋势,计算各指标的估算年度变化百分比(estimated annual percentage change,EAPC)。此外,采用贝叶斯模型预测2020—2044年我国丙型肝炎相关疾病的疾病负担变化趋势。结果1990—2019年,我国丙型肝炎相关疾病患病率、发病率、死亡率及DALY率总体均呈下降趋势(EAPC=-2.64%、-2.24%、-3.81%、-3.90%),但2015—2019年发病率和患病率呈小幅回升。2019年我国丙型肝炎相关疾病总患病率为1254.1/10万,较1990年(2152.7/10万例)下降了41.7%;总发病率为55.0/10万,较1990年(87.9/10万)下降了37.4%,其中发病率最高的是AHC,其次为CLD和肝癌;丙型肝炎相关疾病死亡率为4.0/10万、DALY率为100.8/10万,其中CLD对死亡率和DALY率贡献最大。2019年,我国男性丙型肝炎相关疾病死亡率和DALY率分别为5.5/10万和142.4/10万,均远高于女性(2.8/10万和60.3/10万);各年龄组中,70~岁组丙型肝炎相关疾病总患病率(1604.9/10万)、死亡率(30.2/10万)及DALY率(437.1/10万)均最高,0~9岁组(167.3/10万)发病率最高。贝叶斯模型预测结果表明,2020—2044年我国丙型肝炎相关疾病发病率将呈上升趋势、DALY率将呈下降趋势。结论虽然1990—2019年我国丙型肝炎相关疾病的疾病负担总体呈下降趋势,但疾病负担仍较重,且未来25年发病率仍可能轻度上升,需重点关注婴幼儿丙型肝炎筛查诊治及成人患者治�Objective To measure the burden of hepatitis C⁃associated diseases in China from 1990 to 2019,and to predict its changes from 2020 to 2044,so as to provide insights into formulation of the targeted hepatitis C control strategy.Methods The total burden due to hepatitis C⁃associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019(GBD 2019)data resources,and the trends in age⁃standardized prevalence,incidence,mortality and disability⁃adjusted life years(DALYs)rate of hepatitis C⁃associated acute hepatitis C(AHC),chronic liver diseases(CLD)and liver cancer in China from 1990 to 2019 were evaluated in China from 1990 to 2019 using estimated annual percentage change(EAPC).In addition,the changes in the burden of hepatitis C⁃associated diseases were predicted in China from 2020 to 2044 using a Bayesian model.Results The prevalence,incidence,mortality and DALY rate of hepatitis C⁃associated diseases all appeared an overall tendency towards a decline in China from 1990 to 2019(EAPC=−2.64%,−2.24%,−3.81%and−3.90%,respectively);however,there was a minor rise in the incidence and prevalence of hepatitis C⁃associated diseases from 2015 to 2019.The overall prevalence of hepatitis C⁃associated diseases reduced from 2152.7/105 in 1990 to 1254.1/105 in 2019 in China,with a reduction of 41.7%.The overall incidence reduced from 87.9/105 in 1990 to 55.0/105 in 2019 in China,with a reduction of 37.4%,and the highest incidence was seen for AHC,followed by CLD and liver cancer.The overall mortality and DALYs rate of hepatitis C⁃associated diseases was 4.0/105 and 100.8/105 in China from 1990 to 2019,with CLD showing the largest contributions to the gross mortality and DALYs.The mortality and DALY rate of hepatitis C⁃associated diseases were 5.5/105 and 142.4/105 among men in China in 2019,which were both much higher than among women(2.8/105 and 60.3/105,respectively),and the overall prevalence(1604.9/105),mortality(30.2/105)and DALYs(437.1/105)of hepatitis C⁃assoc

关 键 词：丙型病毒性肝炎 疾病负担 伤残调整寿命年 发病率 患病率 死亡率 估算年度变化百分比 

分 类 号：R512.62[医药卫生—内科学]