1990—2025年我国高发慢性病的流行趋势及预测

The epidemic trend and prediction of chronic diseases with high incidence in China from 1990 to 2025

目的了解我国高发慢性病流行情况及其相关影响因素,预测慢性病未来的流行趋势,为预防控制慢性病提供理论依据。方法利用1990—2017年全球疾病负担(GBD)高发慢性病患病率和疾病负担数据,同时从世界银行数据库(World Bank)获取高发慢性病相关影响因素数据。应用SPSS 19.0比较我国高发慢性病间患病率流行情况,应用逐步回归分析探索各相关影响因素与高发慢性病间的关联,应用ARIMA时间序列预测模型对高发慢性病未来趋势进行预测。结果1990—2017年我国高发慢性病患病率均呈持续增长趋势,慢性阻塞性肺疾病(COPD)和脑卒中的患病率一直高于全球水平;脑卒中的年平均增长率最高,为2.97%,COPD最低,为0.02%;女性的心血管疾病(CVD)和缺血性心脏病患病率均高于男性,且差距呈现逐渐增大趋势。农村人口、65岁及以上人口占总人口的百分比和吸烟率是CVD预测模型的影响因素(P<0.01),城镇人口增长率、二氧化碳排放量和超重发生率是COPD的影响因素(P<0.01),农村人口、农村人口增长率、城镇人口增长率和二氧化碳排放量是糖尿病的影响因素(P<0.01),农村人口、城镇人口增长率、吸烟率和65岁及以上的人口总数是缺血性心脏病的影响因素(P<0.01,P<0.05),老年抚养比、按购买力平价衡量的人均国民总收入(PPPGNI)和农村人口增长率是脑卒中的影响因素(P<0.01)。2018—2025年我国高发慢性病患病率的趋势预测结果显示,CVD、缺血性心脏病与脑卒中的患病率呈现不断增长趋势,CVD患病率由2017年的7551.99/10万上升到2025年的9769.81/10万,缺血性心脏病的患病率由2017年的1612.79/10万上升到2025年的1895.91/10万,脑卒中的患病率由2017年的2393.74/10万上升到2025年的4087.20/10万,而糖尿病与COPD呈现下降趋势,COPD的患病率由2017年的4710.65/10万下降到2025年的3045.41/10万,糖尿病的患病率由2017年的6336.08/10万下降到2025年的5957.94/10万。结论我国高发慢性病患病率仍不断上升,需要提高慢病防控意识,重视慢病高危人群的筛查与防治,实现系统、整合的慢病防控决策与管理。

Objective To understand the prevalence and the influencing factors of chronic diseases with high incidence in China,to predict the prevalence trend in the future,and to provide the theoretical basis for the prevention and control of chronic diseases.Methods Data of the morbidity and disease burden of chronic diseases with high incidence were from Global Burden of Disease(GBD),and the data of influencing factors of chronic diseases with high incidence were from World Bank(WB)during 1990 to2017.The morbidity and disease burden of chronic diseases with high incidence were compared,the influencing factors of chronic diseases with high incidence were analyzed by stepwise regression analysis;ARIMA time series prediction model was used to predict the future prevalence trend of chronic diseases with high incidence.The used software was SPSS 19.0.Results From 1990 to 2017,the morbidity of chronic diseases with high incidence in China had been increasing continuously,the morbidities of chronic obstructive pulmonary disease(COPD)and stroke in China were higher than global levels;the annual average growth rate(2.97%)of stroke was the highest,the annual average growth rate(0.02%)of COPD was the lowest;the morbidities of cardiovascular disease(CVD)and ischemic heart disease in females were higher than those in males,and the difference between females and males was gradually increasing.The rural residents,the proportion of residents≥65 years old and smoking rate were the influencing factors of CVD prediction model(P<0.01);the growing rate of urban residents,carbon dioxide emission and overweight rate were the influencing factors of COPD(P<0.01);the rural population,rural population growth rate,urban population growth rate and carbon dioxide emissions were the influencing factors of diabetes(P<0.01);the rural population,urban population growth rate,smoking rate and total population≥65 years old were the influencing factors of ischemic heart disease(P<0.01);the geriatric dependency ratio,PPPGNI and rural population growth rate were the influencing factors of stroke(P<0.01).The prediction results of morbidity trend for chronic diseases with high incidence from 2018 to 2025 displayed that the morbidities of CVD,ischemic heart disease and stroke showed the increasing trend,the CVD morbidity increased from 7551.99/105 of 2017 to 9769.81/105 of2025,the ischemic heart disease morbidity increased from 1612.79/105 of 2017 to 1895.91/105 of 2025,the stroke morbidity increased from 2393.74/105 of 2017 to 4087.20/105 of 2025,the COPD morbidity decreased from 4710.65/105 of 2017 to 3045.41/105 of 2025,the diabetes morbidity decreased from 6336.08/105 of 2017 to 5957.94/105 of 2025.Conclusion The morbidity of chronic diseases with high incidence increased,the awareness of prevention and control of chronic diseases should be improved,the screening and prevention or treatment of residents with high risk of chronic diseases should be emphasized,the systematic and integrated decision and management of chronic disease prevention and control was realized.