1990—2021年中国归因于高LDL-C的卒中死亡负担变化趋势及预测分析  

Trends and Predictive Analysis of the Burden of Stroke Deaths Attributable to High LDL-C in China from 1990 to 2021

作　　者：张永庆 李娜 高伊丽[1,2] 秦佳文 俞海萍 赵婷婷 ZHANG Yongqing;LI Na;GAO Yili;QIN Jiawen;YU Haiping;ZHAO Tingting(School of Medicine,Tongji University,Shanghai 200331,China;Department of Nursing,Shanghai East Hospital,Shanghai 200120,China;Department of Neurosurgery,Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China)

机构地区：[1]同济大学医学院,上海200331 [2]上海市东方医院护理部 [3]海军军医大学第三附属医院神经外科

出　　处：《中国卒中杂志》2025年第4期447-456,共10页Chinese Journal of Stroke

基　　金：海军军医大学第三附属医院腾飞工程人才项目(TF2024XSJJ03)。

摘　　要：目的分析1990—2021年中国归因于高LDL-C的卒中死亡负担变化趋势,探讨年龄、时期、队列因素的影响,并预测未来死亡负担变化。方法基于2021年全球疾病负担数据库中1990—2021年中国≥20岁人群归因于高LDL-C的卒中死亡负担数据,运用Joinpoint回归模型分析年龄标化死亡率随时间的变化趋势,通过年龄-时期-队列模型估算中国归因于高LDL-C的卒中死亡率的年龄、时期和队列效应,使用整合移动平均自回归(autoregressive integrated moving average,ARIMA)模型预测2022—2030年中国归因于高LDL-C的卒中死亡负担。结果相较于1990年,2021年中国归因于高LDL-C的卒中死亡数、死亡率均明显增长,年龄标化死亡率有所下降。2021年全人群、男性和女性死亡数分别为30.01万例、17.05万例和12.95万例,较1990年分别升高161.87%、187.04%和134.60%;2021年全人群、男性和女性死亡率分别为21.08/10万、23.42/10万和18.64/10万,较1990年分别升高116.65%、139.22%和92.56%;2021年全人群、男性和女性年龄标化死亡率分别为15.93/10万、20.96/10万和12.36/10万,年度变化百分比估计值分别为-0.43%、-0.02%和-0.88%(均P<0.05)。Joinpoint回归模型分析结果显示,1990—2021年中国归因于高LDL-C的卒中年龄标化死亡率整体呈先升后降趋势,且男性的年龄标化死亡率高于女性。年龄-时期-队列模型分析结果显示,归因于高LDL-C的卒中死亡率总体上随年龄的增长而增加,全人群、男性、女性的RR变化范围分别为0.028~12.214、0.027~14.661和0.032~15.258;随时期推移呈上升趋势,全人群、男性、女性RR变化范围分别为0.677~1.418、0.623~1.532和0.750~1.298;总体上随着队列变化呈下降趋势,全人群、男性、女性RR变化范围分别为0.213~4.210、0.221~3.637和0.170~3.978。ARIMA模型预测结果显示,2022—2030年中国归因于高LDL-C的全人群、男性和女性卒中死亡数和死亡率将持续升高,男性年龄标化Objective To analyze the trends in the burden of stroke deaths attributable to high LDL-C in China from 1990 to 2021,explore the effects of age,period,and cohort factors,and predict the future changes in the burden of death.Methods Using the data from the global burden of disease database 2021 on stroke deaths attributable to high LDL-C in Chinese adults aged≥20 years from 1990 to 2021,the Joinpoint regression model was used to analyze the trends of age-standardized death rates over time.Through the age-period-cohort model,the age,period,and cohort effects of stroke deaths attributable to high LDL-C in China were estimated.The autoregressive integrated moving average(ARIMA)model was used to predict the burden of stroke deaths attributable to high LDL-C in China from 2022 to 2030.Results Compared with 1990,the number and rate of stroke deaths attributable to high LDL-C in China have significantly increased in 2021,while the age-standardized death rates has decreased.In 2021,the total number of deaths for the whole population,males,and females were 300100,170500,and 129500,respectively,which were 161.87%,187.04%,and 134.60%higher than those in 1990.The mortality rates in 2021 were 21.08/100000,23.42/100000,and 18.64/100000,respectively,which were 116.65%,139.22%,and 92.56%higher than those in 1990.The age-standardized death rates in 2021 were 15.93/100000,20.96/100000,and 12.36/100000,with estimated annual percentage changes of-0.43%,-0.02%,and-0.88%,respectively(all P<0.05).The results of the Joinpoint regression model showed that from 1990 to 2021,the age-standardized death rates of stroke attributable to high LDL-C in China showed a trend of first increasing and then decreasing in general,and the age-standardized death rates were higher in males than in females.The results of the age-period-cohort model analysis showed that the stroke mortality rates attributable to high LDL-C generally increased with age,with RR ranging from 0.028 to 12.214 in the whole population,0.027 to 14.661 in males,and 0.032 to 15.258

关 键 词：卒中 低密度脂蛋白胆固醇 全球疾病负担 Joinpoint回归 年龄-时期-队列模型 

分 类 号：R74[医药卫生—神经病学与精神病学] R18[医药卫生—临床医学]