全球钙化性主动脉瓣疾病负担的性别和年龄别差异研究  

Sex and age distribution of global disease burden of calcific aortic valve disease

作　　者：邓湘宁[1] 隋鑫宇 李楠[2] 冯杰莉[1] 陈少敏[1] 徐昕晔[1] 唐熠达 汪宇鹏[1] DENG Xiangning;SUI Xinyu;LI Nan;FENG Jieli;CHEN Shaomin;XU Xinye;TANG Yida;WANG Yupeng(Department of Cardiology,Peking University Third Hospital,National Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,Beijing 100191,China;Research Center of Clinical Epidemiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院心血管内科国家卫生健康委心血管分子生物学与调节肽重点实验室,北京100191 [2]北京大学第三医院临床流行病学研究中心,北京100191

出　　处：《浙江大学学报(医学版)》2025年第1期21-27,I0019-I0021,共10页Journal of Zhejiang University(Medical Sciences)

基　　金：国家重点研发计划(2023YFC2414403)。

摘　　要：目的:基于全球疾病负担(GBD)2021研究数据,分析1990—2021年全球钙化性主动脉瓣疾病(CAVD)负担的性别和年龄别差异。方法:从健康指标与评估研究所官方网站获取GBD 1990—2021年CAVD相关数据,分析患病率、死亡率、伤残损失生命年(YLD)和伤残调整生命年(DALY)等指标在不同性别和年龄组的分布特征及变化趋势。采用Joinpoint回归分析计算年变化百分比(APC)和平均年变化百分比(AAPC)。结果:2021年全球CAVD患者达1332万例,导致14.2万例死亡。年龄标化患病率男性(193.2/10万)高于女性(128.9/10万)。年龄分层分析显示,65~<85岁人群占CAVD患者的64.0%,85岁及以上超高龄者占16.1%。1990—2021年,男性和女性CAVD患病率均呈总体上升趋势,AAPC分别为0.72%和0.57%,男性增幅更大,且均在2000—2010年增长最快,此后增速放缓,2015—2021年转为下降。死亡率分析显示性别差异随年龄增长而改变:65岁以下患者中男性死亡率为女性的2.4倍,但在85岁及以上患者中出现逆转,女性死亡率(117.3/10万)超过男性(99.1/10万)。YLD率随年龄增长而上升,但幅度小于死亡率,且各年龄组中男性均高于女性。DALY率总体呈下降趋势,但在85岁及以上患者中呈上升趋势,且女性升幅更为显著。结论:CAVD疾病负担存在显著的性别和年龄别差异,老年群体尤其是超高龄女性的疾病负担需要特别关注,建议制订个性化的干预策略。Objective:To analyze sex and age distribution of global disease burden of calcific aortic valve disease(CAVD)from 1990 to 2021.Methods:CAVD data during 1990—2021 were obtained from the IHME website for Global Burden of Disease(GBD).The prevalence,mortality,years lived with disability(YLDs),and disability-adjusted life years(DALYs)were analyzed by gender and age groups.Joinpoint regression was used to calculate annual percentage change(APC)and average annual percentage change(AAPC).Results:In 2021,there were 13.32 million CAVD patients and 142000 deaths caused by CAVD globally.Age-standardized prevalence was higher in males(193.2/105)than that in females(128.9/105).Patients in 65-<85 age group accounted for 64.0%of total cases,while those≥85 years old accounted for 16.1%.From 1990 to 2021,prevalence increased in both sexes with an AAPC of 0.72%for males and 0.57%for females,respectively.Prevalence grew fastest from 2000 to 2010,slowed thereafter,and declined from 2015 to 2021.In<65 years old,the mortality of males was 2.4 times higher than that of females,while in≥85 years old,mortality of females(117.3/105)exceeded that of males(99.1/105).YLD rates increased with age,and were higher in males for all age groups.DALY rates decreased overall but increased in≥85 years old,with a greater increase in females.Conclusions:There are significant gender and age disparities in global disease burden of CAVD,with the elderly,especially super-elderly females deserving particular attention.It is recommended to develop personalized intervention strategies for these populations.

关 键 词：钙化性主动脉瓣疾病 全球疾病负担 性别差异 年龄别差异 

分 类 号：R542.5[医药卫生—心血管疾病]