中国急性乙型肝炎疾病负担趋势及预测分析
DOI: 10.3969/j.issn.1001-5256.2023.11.010
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摘要:
目的 了解1990—2019年中国急性乙型肝炎负担情况及发展趋势。 方法 利用2019年全球疾病负担数据库,分析不同性别及年龄组急性乙型肝炎的发病率、死亡率及伤残调整寿命年(DALY)率,并对急性乙型肝炎发病率趋势进行预测。 结果 2019年我国急性乙型肝炎的发病率、死亡率和DALY率分别为1 623.71/10万、0.20/10万和10.04/10万,与1990年相比分别降低了42.03%、79.38%和80.21%,并且女性急性乙型肝炎的发病率、死亡率和DALY率低于男性。2019年发病率和DALY率最高的年龄组均为20~<54岁年龄组,分别为2 285.85/10万和10.53/10万,死亡率最高的年龄组为≥55岁年龄组,为0.52/10万。Joinpoint回归模型结果显示,1990—2019年中国急性乙型肝炎发病率、死亡率和DALY率均呈降低趋势,平均年度变化百分比分别为-1.9%、-5.2和-5.5%,差异均有统计学意义(P值均<0.05)。灰色预测模型GM(1,1)预测结果显示,2020—2030年我国急性乙型肝炎的发病率呈下降趋势。 结论 1990—2019年中国急性乙型肝炎负担呈降低趋势,表明我国对急性乙型肝炎的防治效果显著,但我国人口基数大,应继续采取积极的预防措施以减急性乙型肝炎的疾病负担。 Abstract:Objective To investigate the situation and development trend of the disease burden of acute hepatitis B in China in 1990 — 2019. Methods The Global Burden of Disease 2019 was used to analyze the incidence rate, mortality rate, and disability-adjusted life year (DALY) rate of acute hepatitis B in different sex and age groups and predict the trend of the incidence rate of acute hepatitis B. Results In 2019, the incidence rate, mortality rate, and DALY rate of acute hepatitis B in China were 1 623.71/100 000, 0.20/100 000, and 10.04/100 000 respectively, which were reduced by 42.03%, 79.38%, and 80.21%, respectively, compared with the data in 1990, and women showed lower incidence rate, mortality rate, and DALY rate of acute hepatitis B than men. In 2019, the 20~<54 years group had the highest incidence rate (2 285.85/100 000) and DALY rate (10.53/100 000), and the ≥55 years group had the highest mortality rate of 0.52/100 000. The Joinpoint regression model analysis showed that the incidence rate, mortality rate, and DALY rate of acute hepatitis B in China tended to decrease from 1990 to 2019, with an average annual percent change of -1.9%, -5.2%, and -5.5%, respectively (P<0.05). The grey prediction model GM (1,1) showed that the incidence rate of acute hepatitis B will decrease from 2020 to 2030 in China. Conclusion The disease burden of acute hepatitis B tended to decrease from 1990 to 2019 in China, indicating that the prevention and treatment measures for acute hepatitis B have achieved a marked effect in China; however, due to the large population base of China, active preventive measures should be further adopted to reduce the disease burden of acute hepatitis B. -
Key words:
- Acute Hepatitis B /
- Cost of Illness /
- Forecasting
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表 1 1990年和2019年急性乙型肝炎负担情况
Table 1. Disease burden of acute hepatitis B in 1990 and 2019
变量 男性 女性 合计 1990年 2019年 变化率(%) 1990年 2019年 变化率(%) 1990年 2019年 变化率(%) 发病例数(万) 2 085.75 1 490.39 -28.54 1 229.77 819.10 -33.39 3 315.53 2 309.49 -30.34 发病率(/10万) 3 418.23 2 056.22 -39.85 2 144.35 1 174.29 -45.24 2 801.03 1 623.71 -42.03 死亡例数(万) 0.70 0.21 -70.00 0.44 0.08 -81.82 1.15 0.29 -74.78 死亡率(/10万) 1.15 0.28 -75.65 0.77 0.12 -84.42 0.97 0.20 -79.38 DALY(/万人年) 36.73 10.08 -72.56 23.31 4.20 -81.98 60.04 14.28 -76.22 DALY率(/10万) 60.20 13.91 -76.89 40.64 6.03 -85.16 50.72 10.04 -80.21 表 2 1990年和2019年不同年龄组急性乙型肝炎疾病负担情况
Table 2. Disease burden of acute hepatitis B in different age groups in 1990 and 2019
年龄组 发病率(/10万) 死亡率(/10万) DALY率(/10万) 男性 女性 合计 男性 女性 合计 男性 女性 合计 <20岁 1990年 2 573.40 1 733.84 2 169.89 0.58 0.61 0.59 50.07 54.35 53.17 2019年 237.15 153.66 198.63 0.04 0.03 0.04 3.68 3.11 3.42 变化率(%) -90.78 -91.14 -90.85 -93.10 -95.08 -93.22 -92.65 -94.28 -93.57 20~<54岁 1990年 4 256.72 2 603.28 3 460.55 1.07 0.39 0.74 59.74 24.16 42.60 2019年 2 895.16 1 653.91 2 285.85 0.20 0.04 0.12 15.31 5.58 10.53 变化率(%) -31.99 -36.47 -33.95 -81.31 -89.74 -83.78 -74.37 -76.90 -75.28 ≥55岁 1990年 2 589.02 1 579.85 2 075.62 3.41 2.73 3.07 52.48 34.55 42.96 2019年 1 849.67 951.78 1 388.02 0.71 0.34 0.52 11.02 4.71 7.69 变化率(%) -28.55 -39.75 -33.12 -79.17 -87.54 -83.06 -79.00 -86.36 -82.09 表 3 1990—2019年急性乙型肝炎疾病负担趋势分析
Table 3. Trend analysis of disease burden of acute hepatitis B from 1990 to 2019
注:1)代表APC值有统计学意义,P<0.05。 表 4 1990—2019年我国与全球及不同SDI地区急性乙型肝炎疾病负担
Table 4. Disease burden of acute hepatitis B in China, the World and different SDI regions from 1990 to 2019
地区 发病率(/10万) DALY率(/10万) 1990年 2019年 变化率 1990年 2019年 变化率 中国 2 801.03 1 623.71 -42.03 50.72 10.04 -80.21 全球 1 569.14 1 034.23 -34.09 43.81 20.86 -52.39 高SDI地区 620.76 408.18 -34.25 3.49 2.13 -38.97 中高SDI地区 1 364.38 823.64 -39.63 23.16 8.06 -65.20 中SDI地区 2 047.46 1 186.58 -42.05 54.60 19.58 -64.14 中低SDI地区 1 524.96 1 089.32 -28.57 63.87 33.27 -47.91 低SDI地区 2 033.10 1 454.42 -28.46 73.65 37.27 -49.40 -
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