中国1990—2019年代谢因素对缺血性心脏病疾病负担的长期影响及趋势研究  

A Long-term Study on the Long-term Impact of Demographic Factors on the Burden of Ischemic Heart Disease in China from 1990 to 2019

作　　者：张馨月 张良文[1,2] 方亚 ZHANG Xinyue;ZHANG Liangwen;FANG Ya(School of Public Health,Xiamen University,Xiamen 361102,China;Fujian University Key Laboratory of Health Technology Evaluation,Xiamen 361102,China)

机构地区：[1]厦门大学公共卫生学院,福建省厦门市361102 [2]福建省高校卫生技术评估重点实验室,福建省厦门市361102

出　　处：《中国全科医学》2024年第27期3388-3394,共7页Chinese General Practice

基　　金：国家重点研发计划资助项目(2022YFC3603000)。

摘　　要：背景缺血性心脏病(IHD)负担日趋沉重,代谢因素影响逐渐加重,且当前在探讨因代谢因素所致的IHD疾病负担及其变化趋势方面,尚存在研究不足的情况。目的深入分析中国1990—2019年,由于代谢因素所造成的IHD疾病负担的长期影响及其变化趋势,从而为IHD的预防与控制工作提供坚实而有力的科学支撑与依据。方法基于2019年全球疾病负担研究数据,获取1990—2019年中国不同年龄、性别IHD归因于代谢因素的死亡率、伤残调整寿命年(DALY)率及其相应标化指标。运用Joinpoint模型对疾病变化的时间趋势进行系统的评估。结果中国全人群归因于代谢因素的IHD死亡率和DALY率分别从1990年的38.01/10万、944.68/10万上升至2019年的103.34/10万、1972.50/10万。与1990年相比,2019年中国居民归因于代谢因素的IHD死亡率、DALY率及其相应标化指标均表现为男性高于女性,高年龄组高于低年龄组的特点。就性别而言,1990—2019年中国归因于代谢因素的IHD男性的标化死亡率逐渐高于全球水平,而全人群、女性标化死亡率始终低于全球水平。三者标化DALY率均显著低于全球水平。就年龄而言,1990—2019年归因于高BMI的DALY率在人群中均呈上升趋势并占据主导地位,肾功能不全在老年人群中逐渐凸显。结论自1990年以来,中国的IHD疾病负担总体上呈现出上升趋势。代谢因素导致的IHD疾病负担日趋加重,应继续加大IHD防控的宣传力度,尤其是针对男性、老年人等重点人群,开展针对性健康管理,更好地指导卫生政策的制定,提高卫生资源的利用效率,优化医疗服务的布局结构,以更好地满足公众健康需求,更大程度减轻中国IHD疾病负担,助力健康中国目标的实现。Background The disease burden of ischemic heart disease is becoming heavier,and the influence of metabolic factors is gradually increasing,and there is still insufficient research in exploring the disease burden caused by metabolic factors and its change trend.Objective To analyzes the long-term impact and trend of the disease burden of ischemic heart disease caused by metabolic factors in China from 1990 to 2019,so as to provide solid and powerful scientific support and basis for the prevention and control of ischemic heart disease.Methods Based on the data of the Global Burden of Disease Study in 2019,the mortality rate,disability adjusted life year(DALY)and corresponding normalized indicators attributed to metabolic factors in ischemic heart disease of different ages and sexes in China from 1990 to 2019 were obtained.The Joinpoint model was used to systematically evaluate the temporal trend of disease changes.Results The mortality rate and DALY rate of ischemic heart disease attributed to metabolic factors in the whole population of China increased from 38.01/100000 and 944.68/100000 in 1990 to 103.34/100000 and 1972.50/100000 in 2019,respectively.Compared with 1990,in 2019,the mortality rate of ischemic heart disease,DALY rate and corresponding standardized indicators attributed to metabolic factors were significantly higher in males than in females,and higher in the older age group than in the lower age group.In terms of gender,during the period of 1990—2019,the standardized mortality rate of men with IHD attributed to metabolic factors in China was gradually higher than the global level,while the standardized mortality rate of the whole population and women was always lower than the global level.The standardized DALY rates of all three are significantly lower than the global level.In terms of age,the DALY rate attributed to high body mass index in 1990—2019 showed an upward trend and dominated the population,and renal insufficiency gradually became prominent in the elderly population.Conclusion Since 19

关 键 词：缺血性心脏病 代谢因素 疾病负担 全球疾病负担研究 Joinpoint模型 

分 类 号：R542.2[医药卫生—心血管疾病]