1990—2021年中国14周岁以下儿童先天性心脏疾病疾病负担水平及其变化趋势  

Analysis of the burden and changes of congenital heart disease among children under 14 years old in China from 1990 to 2021

作　　者：陈果 黄子睿 程雁[1] 杨旻[2] CHEN Guo;HUANG Zirui;CHENG Yan;YANG Min(Department of Pediatrics,The Second Hospital of Anhui Medical University,Hefei 230601,China;Department of Intensive Care Unit,The Second Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院儿科,合肥230601 [2]安徽医科大学第二附属医院重症医学二科,合肥230601

出　　处：《医学新知》2025年第2期123-130,共8页New Medicine

基　　金：国家自然科学基金面上项目(82072134)。

摘　　要：目的分析1990—2021年我国14周岁以下儿童先天性心脏疾病(congenital heart disease,CHD)的疾病负担及其变化趋势。方法根据2021年全球疾病负担研究(Global Burden of Disease Study 2021,GBD 2021)数据库,分析1990—2021年我国0~14岁儿童CHD的发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)率及其平均年度百分比变化率(average annual percent change,AAPC),以及不同年龄、性别CHD负担情况。结果我国2021年CHD发病率为1615.39/10万,死亡率为5.39/10万,DALY率为504.05/10万人年,较1990年分别下降16.10%、85.04%和84.34%,下降趋势快于同期全球水平。1990—2021年我国CHD发病率、死亡率及DALY率的AAPC分别为-0.57[95%CI(-0.62,-0.51)]、-6.01[95%CI(-6.35,-5.67)]、-5.84[95%CI(-6.19,-5.50)]。男性患儿CHD发病率均高于女性患儿,死亡率及DALY率除2~4岁区间外均高于女性。0~28 d患儿死亡率、DALY率最高,随着年龄增长逐渐下降,10~14岁最低。在不同社会人口学指数(sociodemographic index,SDI)地区中,1990—2021年我国0~14岁儿童CHD的发病率、死亡率和DALY率的降幅均大于各SDI地区。结论我国CHD发病率、死亡率、DALY率均呈下降趋势,且死亡率下降速度快于全球平均水平,但发病率和死亡率与高SDI地区间仍存在差距。我国需积极完善CHD的治疗手段,多方面改善CHD患儿的预后。Objective Analysis of the disease burden and trends of congenital heart disease(CHD)among children under 14 years of age in China from 1990 to 2021.Methods Based on the Global Burden of Disease Study 2021(GBD 2021)database,incidence,mortality,disabilityadjusted life year(DALY),and average annual percent change(AAPC)were employed as indicators to assess the burden of CHD among children under 14 years of age in China and globally from 1990 to 2021.The burden of CHD across various age groups and genders within China were also delineated.Results In 2021,the incidence rate of CHD in China was 1,615.39/100,000,the mortality rate was 5.39/100,000,and the DALY rate was 504.05/100,000 person years.Compared to 1990,these rates have decreased by 16.10%,85.04%,and 84.34%,respectively,with a significantly faster decline trend than the global average during the same period.The AAPC for the incidence,mortality,and DALY rates of CHD in China from 1990 to 2021 were-0.57[95%CI(-0.62,-0.51)],-6.01[95%CI(-6.35,-5.67)],and-5.84[95%CI(-6.19,-5.50)],respectively.The incidence rate of CHD in male children was higher than in female children,and the mortality rate and DALY were higher than in females except in the 2~4 years age group.The mortality and DALY rates were highest in children aged 0~28 days group and gradually decreased with age,being lowest in children aged 10~14 years group.In different sociodemographic index(SDI)regions,the incidence rate,mortality and DALY rate of CHD in children aged 0~14 years in China have decreased more than those in SDI regions from 1990 to 2021.Conclusion The incidence,mortality,and DALY rates for CHD in China have all shown a downward trend,with the rate of mortality decline being particularly rapid and exceeding the global average.However,there remains a gap between the incidence and mortality rates in China and those in regions with high SDI.This suggests that China still needs to enhance and improve the treatment methods for CHD to improve the prognosis of CHD children.

关 键 词：先天性心脏疾病 疾病负担 发病率 死亡率 伤残调整寿命年 变化趋势 

分 类 号：R725.4[医药卫生—儿科]