1990~2021年中国年龄相关性黄斑变性疾病负担的年龄-时期-队列分析及预测研究  

Age-period-cohort analysis and prediction of the disease burden of age-related macular degeneration in China from 1990 to 2021

作　　者：谢婧 王正静 杨梅[1] 胡红芳 冯亮 赵粟[1,2] XIE Jing;WANG Zhengjing;YANG Mei;HU Hongfang;FENG Liang;ZHAO Su(Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Department of Ophthalmology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Guiyang Aier Eye Hospital,Guiyang 550005,Guizhou Province,China)

机构地区：[1]贵州医科大学,贵州省贵阳市550004 [2]贵州医科大学附属医院眼科,贵州省贵阳市550004 [3]贵阳爱尔眼科医院,贵州省贵阳市550005

出　　处：《眼科新进展》2025年第1期33-38,共6页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助项目(编号:82260208);贵州医科大学博士启动基金项目(编号:gyfybsky-2022-06)。

摘　　要：目的分析1990~2021年中国年龄相关性黄斑变性(AMD)疾病负担变化趋势及年龄、时期和队列效应产生的影响,预测2022~2035年中国AMD患者的标化患病率和标化伤残调整寿命年(DALYs)的DALY率。方法从2021年全球疾病负担数据库中获取1990~2021年中国AMD患病率、患病人数、DALYs和DALY率数据,采用分段回归模型分析中国AMD患者患病和DALYs的趋势变化,运用年龄-时期-队列(APC)模型估算AMD患病风险和DALY风险的年龄、时期和队列效应,并使用贝叶斯年龄-时期-队列模型预测2022~2035年中国AMD的标化患病率和标化DALY率。结果2021年中国AMD患病人数和患病率较1990年分别升高199.94%和148.02%,2021年DALYs和DALY率较1990年分别升高183.95%和134.80%,其中女性的相关指标均高于男性。1990~2021年AMD标化患病率呈现上升趋势,平均年度变化百分比(AAPC)为0.17%。AMD标化DALY率呈现下降趋势,AAPC为-0.03%。APC模型结果显示,中国AMD患病率和DALY率的纵向年龄曲线呈先上升后下降的趋势,在85~89岁时达高峰。随着时期的推移,AMD的患病风险呈先上升后下降的趋势,DALY风险随时期的增加呈下降趋势。出生队列结果显示,我国AMD患病风险队列效应整体波动不大,呈现先下降后波动式上升的趋势,DALY风险则随着出生队列时间的后移逐渐降低。预测2022~2035年中国AMD的标化患病率和标化DALY率均呈现上升趋势。结论1990~2021年中国AMD的标化患病率呈上升趋势,标化DALY率呈下降趋势,并且女性群体疾病负担高于男性,随着人口老龄化的加剧,预测2022~2035年中国AMD的标化患病率和标化DALY率仍将持续上升,根据我国人群AMD患病和DALYs的相关特点,提示有关部门应重视对老年女性群体的干预,同时应加强对全人群的健康科普教育并制定有效的公共卫生预防政策,以期降低我国AMD造成的重大疾病负担。Objective To analyze the changing trend of the disease burden of age-related macular degeneration(AMD)in China from 1990 to 2021 and the impact of age,period,and cohort effects,and to predict the standardized prevalence and disability-adjusted life year(DALY)rate of AMD in China from 2022 to 2035.Methods The data on the prevalence of AMD,the number of AMD patients,DALYs,and DALY rates in China from 1990 to 2021 were obtained from the Global Burden of Disease(GBD 2021).The segmented regression model was used to analyze the trend changes in the prevalence and DALY of patients with AMD in China,the age-period-cohort(APC)model was employed to estimate the age,period,and cohort effects related to the prevalence risk and DALY risk of AMD,and the Bayesian age-period cohort model was used to analyze the standardized prevalence and DALY rate of AMD in China from 2022 to 2035.Results Compared with 1990,the number of AMD patients and the prevalence of this disease in China in 2021 increased by 199.94%and 148.02%,respectively,and the DALYs and DALY rate increased by 183.95%and 134.80%,respectively,with the higher value of relevant indicators observed in females compared with males.From 1990 to 2021,the standardized prevalence of AMD in China showed an increasing trend,with the average annual percentage change(AAPC)being 0.17%.In contrast,the standardized DALY rate of AMD showed a decreasing trend,with the AAPC being-0.03%.The results of the age-period-cohort model showed that the longitudinal age curves for both the prevalence and DALY rate of AMD in China showed an increasing and then decreasing trend,peaking at 85-89 years of age.Over time,the prevalence risk of AMD increased and then decreased,while the DALY risk continued to decline.The birth cohort analysis results showed that the overall fluctuation of the AMD prevalence risk cohort effect in China was small,with a decline first and then a fluctuating increase.Meanwhile,the DALY risk gradually decreased as the birth cohort moved backward.It can be predicted that both t

关 键 词：年龄相关性黄斑变性 全球疾病负担 患病率 伤残调整寿命年 分段回归模型 年龄-时期-队列模型 

分 类 号：R774.5[医药卫生—眼科]