1990—2021年“一带一路”共建国家40岁及以上人群下肢外周动脉疾病负担及公平性分析  

Analysis of burden and equality of lower extremity peripheral artery disease in people aged 40 and above in the Belt and Road partner countries from 1990 to 2021

作　　者：沈广电 朱隆珠 应佳瑶 单诗怡 罗泽宇 蒋德楠 吴静 朱越锋 SHEN Guangdian;ZHU Longzhu;YING Jiayao;SHAN Shiyi;LUO Zeyu;JIANG Denan;WU Jing;ZHU Yuefeng(The Fourth Affiliated Hospital,Zhejiang University School of Medicine,International Institute of Medicine,International School of Medicine,Zhejiang University,Yiwu 322000,Zhejiang Province,China;School of Public Health,Zhejiang University School of Medicine,Hangzhou 310058,China;Vascular Surgery Department,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属第四医院国际健康医学研究院“一带一路”国际医学院,浙江义乌322000 [2]浙江大学医学院公共卫生学院,浙江杭州310058 [3]浙江大学医学院附属邵逸夫医院血管外科,浙江杭州310016

出　　处：《浙江大学学报(医学版)》2025年第1期10-20,I0002-I0018,共28页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的:评估1990至2021年“一带一路”共建国家40岁及以上人群下肢外周动脉疾病(LEPAD)的负担情况和不公平性,为疾病防治提供依据。方法:利用2021年全球疾病负担数据库,分析155个“一带一路”共建国家40岁及以上人群的LEPAD年龄标化患病率、死亡率和伤残损失生命年(YLD)率,变化趋势使用估计年变化百分比(EAPC)衡量。采用不平等斜率指数和集中指数量化国家间LEPAD负担的绝对不公平和相对不公平。结果:2021年“一带一路”共建国家40岁及以上人群LEPAD的年龄标化患病率为3168.26/10万,死亡率为3.09/10万,较1990年分别增加4.30%和19.31%。1990至2021年,YLD率从16.23/10万降至15.58/10万,降幅达4.00%。女性患病率和YLD率高于男性,男性死亡率则高于女性。男性的年龄标化患病率EAPC为0.22%,略高于女性的0.17%;女性年龄标化死亡率的EAPC为2.02%,高于男性的1.45%。女性的年龄标化YLD率下降速度快于男性,EAPC分别为-0.12%和-0.06%。不同国家间LEPAD负担差异显著,欧洲国家负担普遍较高,海湾国家负担增长速度更快。LEPAD患病率与社会人口指数(SDI)相关,高SDI国家的LEPAD患病率较高。公平性分析显示,2021年“一带一路”共建国家年龄标化YLD率的不平等斜率指数为52.90/10万,年龄标化YLD数的集中指数为0.038,较1990年下降,表明各国的绝对和相对不公平性改善。女性LEPAD的绝对不公平性始终高于男性,相对不公平性也于2021年转变为高于男性(2021年女性和男性的集中指数分别为0.058和-0.026)。结论:“一带一路”共建国家40岁及以上人群LEPAD年龄标化患病率、死亡率持续上升,但YLD率有所下降,不同性别、不同国家间存在差异,提示各国应加强对40岁及以上高风险人群的LEPAD早期筛查和健康教育,共享防控经验,共同提升公共卫生治理能力。Objective:To analyze the disease burden and inequalities of lower extremity peripheral artery disease(LEPAD)among people aged 40 and above in the Belt and Road partner countries from 1990 to 2021.Method:Data were retrieved from the Global Burden of Disease 2021 database.The age-standardized prevalence rates,mortality rates,and the annual rate of years lived with disability(YLDs)of LEPAD were analyzed.Trends were measured using the estimated annual percentage change(EAPC),and the slope index of inequality(SII)and concentration index were used to quantify the absolute and relative inequalities.Results:In 2021,the age-standardized prevalence and mortality rates of LEPAD were 3168.26/105 and 3.09/105,increasing by 4.30%and 19.31%compared to 1990,while YLDs rates decreased by 4.00%.Females had higher age-standardized prevalence and YLDs rates,while males had higher mortality rates.The EAPC for prevalence rates was slightly higher in males(0.22%)than in females(0.17%);while the EAPC of age-standardized mortality rate was 2.02%for females,compared to 1.45%for males.From 1990 to 2021,the age-standardized YLDs rates decreased from 16.23/105 to 15.58/105,with a faster decline in females(-0.12%)than in males(-0.06%).LEPAD prevalence varied across countries,with higher burden in Europe and faster growth in Gulf states.Higher socio-demographic index countries had higher prevalence.Inequity improved,with the SII at 52.90/105 and concentration index at 0.038 in 2021.Gender disparities persisted,with concentration index increased to 0.058 in females and reduced to-0.026 in males.Conclusions:LEPAD prevalence and mortality among people aged 40 and above in the Belt and Road partner countries increased,while YLDs rates decreased from 1990 to 2021.Significant differences among people exist depending on gender and country,highlighting the need for enhanced screening,health education,and shared public health strategies across the Belt and Road partner countries.

关 键 词：下肢外周动脉疾病 全球疾病负担 “一带一路”共建国家 中老年人 

分 类 号：R543[医药卫生—心血管疾病]