1990~2021年中国和全球归因于烟草的缺血性心脏病疾病负担现状及变化趋势研究  

Analysis of disease burden of ischemic heart disease attributed to tobacco in china and globally:Current status and trends from 1990 to 2021

作　　者：闫昱名 付宏利 关礼春 虞敏 YAN Yu-ming;FU Hong-li;GUAN Li-chun;YU min(Department of Cardiovascular Surgery,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院心脏大血管外科,上海市200080

出　　处：《中国心血管病研究》2025年第4期366-372,共7页Chinese Journal of Cardiovascular Research

基　　金：上海市促进市级医院临床技能与临床创新能力三年行动计划(SHDC2020CR3100B)。

摘　　要：目的 探讨1990年至2021年中国和全球归因于烟草的缺血性心脏病(IHD)疾病负担的现状及变化趋势,揭示不同性别、年龄及社会经济发展水平对疾病负担的影响,为控烟政策制定和干预策略优化提供科学依据。方法 本研究基于《全球疾病负担研究2021》(global burden of disease study 2021,GBD2021)数据库,提取1990年至2021年间归因于烟草的IHD疾病负担相关数据,主要指标包括死亡数、死亡率、伤残调整生命年(DALY)、标化死亡率及标化DALY率。通过Joinpoint回归模型分析不同时间段的年度变化百分比(APC)和平均年度变化百分比(AAPC)。此外,根据社会人口指数(SDI)对不同地区的变化趋势进行比较,分析疾病负担的性别和年龄分布特征。结果 研究发现,2021年中国归因于烟草的IHD死亡数和DALY值分别较1990年显著上升184.34%和121.12%,但标化死亡率和标化DALY率无显著变化。相比之下,全球标化死亡率和标化DALY率分别下降40.43%和39.95%。高SDI地区的标化指标下降最为明显,低SDI地区则下降幅度较小。男性因吸烟导致的IHD疾病负担显著高于女性,二手烟对女性的影响显著。此外,疾病负担随年龄增长而增加,老年人群中负担最为突出。结论 尽管全球在控烟政策、健康教育和戒烟服务等方面取得显著成效,中国的烟草相关IHD疾病负担仍处于较高水平,尤其在男性和老年群体中亟待改善。未来应进一步加强控烟立法和政策执行力度,优化公共健康干预,特别是在低SDI地区推广无烟环境建设。针对高风险人群的个性化干预和对二手烟暴露的防控同样至关重要。本研究为中国及全球IHD防治策略的优化提供了重要参考。Objective To assess the current status and trends of the disease burden of ischemic heart disease(IHD) attributable to tobacco use in China and globally from 1990 to 2021,and to further explore the influence of gender,age and socioeconomic development levels on the disease burden,providing scientific evidence for optimizing tobacco control policies and intervention strategies.Methods Data on the disease burden of IHD attributable to tobacco use were extracted from the Global Burden of Disease Study 2021(GBD 2021) for the years 1990 to 2021.The key indicators analyzed included the number of deaths,mortality rates,disabilityadjusted life years(DALY),age-standardized mortality rates(ASMR) and age-standardized DALY rates(ASDR).Temporal trends were examined using the Joinpoint regression model to calculate the annual percentage change(APC) and the average annual percentage change(AAPC).Additionally,regional trends were compared based on the sociodemographic index(SDI),while the gender and age distributions of the disease burden were analyzed.Results From 1990 to 2021,the number of deaths and DALYs attributable to tobacco use in China increased significantly by 184.34% and 121.12%,respectively.However,ASMR and ASDR in China showed no significant changes during this period.Globally,ASMR and ASDR decreased by 40.43% and 39.95%,respectively,with the most pronounced reductions observed in high-SDI regions,while declines were more modest in low-SDI regions.The tobacco-related IHD disease burden was significantly higher among men than women,with second-hand smoke exposure having a notable impact on women.The burden increased with age,peaking among the elderly population.Conclusion Despite substantial global advancements in tobacco control policies,public health education,and smoking cessation initiatives,the tobacco-attributable IHD burden in China remains substantial,particularly among men and older adults.Strengthening tobacco control legislation and policy implementation,along with optimizing public health interventions,i

关 键 词：缺血性心脏病 烟草 全球疾病负担 趋势 

分 类 号：R54[医药卫生—心血管疾病]