基于GBD2021数据库对中国与全球老年人疝疾病负担和健康不平等的分析比较  

Analysis and comparison of disease burden and health inequality of hernias in elderly populations between China and global levels based on GBD2021 study

作　　者：张晋伟 董永红[1,2] 王家璇[3] Zhang Jinwei;Dong Yonghong;Wang Jiaxuan(The Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030012,Shanxi Province,China;The Department of Gastrointestinal,Pancreatic,Hernia and Abdominal Wall Surgery,Shanxi Provincial People's Hospital,Taiyuan 030012,Shanxi Province,China;First Clinical Medical College of Changzhi Medical College,Changzhi 046000,Shanxi Province,China)

机构地区：[1]山西医科大学第五临床医学院,太原030012 [2]山西省人民医院胃肠胰及疝与腹壁外科,太原030012 [3]长治医学院第一临床医学院,山西046000

出　　处：《中华疝和腹壁外科杂志(电子版)》2024年第6期708-716,共9页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的分析1990—2021年中国老年人疝疾病(包括腹股沟疝、股疝、脐疝、膈疝、其他腹部疝,不包括切口疝、造口旁疝和其他未指明的腹疝)负担、变化趋势和健康不平等,并与全球水平进行对比,为我国老年人疝防治相关措施的制定提供依据。方法利用2021年全球疾病负担(GBD2021)研究评估中国老年人疝的疾病负担,采用Joinpoint回归模型分别计算1990—2021年我国和全球老年人疝的各项标化率的平均年百分比变化(AAPC);分解分析揭示老年人疝疾病负担的驱动因素;健康不平衡分析揭示不同社会人口指数(SDI)地区老年人疝疾病负担差距。结果1990—2021年,中国老年人疝疾病的标化发病率、标化患病率和标化伤残调整寿命年(DALY)率均低于全球整体水平。2021年中国老年人疝疾病的标化发病率、标化患病率和标化DALY率分别为82.63/10万、169.35/10万、17.32/10万,全球分别为134.87/10万、330.86/10万、76.23/10万。1990—2021年,中国与全球老年男性疝疾病负担均高于女性。1990—2021年,中国老年人疝疾病的标化发病率呈上升趋势(AAPC=1.19%,P<0.001),而标化患病率(AAPC=-0.64%,P<0.001)和标化DALY率(AAPC=-1.56%,P<0.001)呈下降趋势,全球的标化发病率(AAPC=-1.12%,P<0.001)、标化患病率(AAPC=-1.44%,P<0.001)和标化DALY率(AAPC=-1.64%,P<0.001)均呈下降趋势。1990—2021年,人口增长对中国和全球的疝疾病发病率、患病率和DALY率的上升均呈主要贡献。全球健康不平等现象仍存在,DALY率和患病率的健康不平等现象过度集中在低SDI的国家,发病率的健康不平等现象过度集中在高SDI的国家,中国的健康不平等现象继续加重。结论1990—2021年,中国和全球老年人疝疾病负担整体呈下降趋势,中国负担低于全球水平,2019年后疝疾病负担在逐渐增加,相关疝疾病综合防治仍需重视,男性人群应为防治主要人群,落后地区应为防治主要地区。Objective To analyze the burden,trends,and health inequalities of hernia disease(including inguinal hernia,femoral hernia,umbilical hernia,diaphragmatic hernia,other abdominal hernia,not including incisional hernia,parostomy hernia and other unspecified abdominal hernia)in older adults in China from 1990 to 2021,and to compare these with global levels,providing a basis for formulating prevention and control measures for hernias in the elderly population in China.Methods The Global Burden of Disease 2021(GBD2021)study was used to assess the disease burden of hernias in Chinese older adults.The Joinpoint regression model was employed to calculate the average annual percentage change(AAPC)of standardized rates for hernias in older adults in China and globally from 1990 to 2021.Decomposition analysis was conducted to reveal the driving factors of hernia disease burden in the elderly,and health inequality analysis was performed to reveal disparities in hernia disease burden among older adults across regions with different socio-demographic index(SDI)levels.Results From 1990 to 2021,the age-standardized incidence,prevalence,and disability-adjusted life year(DALY)rates of hernia disease in Chinese older adults were all lower than the global level.In 2021,the age-standardized incidence,prevalence,and DALY rates for hernias in Chinese older adults were 82.63 per 100,000,169.35 per 100,000,and 17.32 per 100,000,respectively,compared to the global rates of 134.87 per 100,000,330.86 per 100,000,and 76.23 per 100,000.From 1990 to 2021,the hernia disease burden in older male adults was higher than that in females in both China and globally.During this period,the age-standardized incidence rate in China showed an upward trend(AAPC=1.19%,P<0.001),while the age-standardized prevalence rate(AAPC=-0.64%,P<0.001)and DALY rate(AAPC=-1.56%,P<0.001)showed downward trends.Globally,the age-standardized incidence(AAPC=-1.12%,P<0.001),prevalence(AAPC=-1.44%,P<0.001),and DALY rates(AAPC=-1.64%,P<0.001)all showed downward trends.Population g

关 键 词：疝 腹股沟 股疝 疾病负担 老年人群 分解分析 健康不平等 

分 类 号：R47[医药卫生—护理学]