1990年与2010年中国心血管病疾病负担研究

The disease burden of cardiovascular and circulatory diseases in China, 1990 and 2010

目的：分析比较中国1990年与2010年心血管病的死亡和疾病负担情况。方法利用2010年全球疾病负担研究结果，主要指标包括死亡数、过早死亡损失寿命年（YLL）、伤残损失寿命年（YLD）和伤残调整寿命年（DALY），同时使用2010年全国人口普查数据作为标准人口，计算标化死亡率、DALY率、YLL率和YLD率，对1990年和2010年中国心血管疾病死亡情况和疾病负担进行描述。计算1990年与2010年相关指标的变化幅度。结果2010年，中国心血管病的死亡总数为313.62万例，死亡率为233.70/10万，标化死亡率为256.90/10万，其所造成的DALY、YLL和YLD分别为5820.55万、5404.88万、415.68万人年，标化DALY率、YLL率和YLD率分别为4639.04/10万、4313.13/10万和325.91/10万；1990年，心血管病死亡数为216.75万例，标化死亡率为300.30/10万，造成的DALY、YLL和YLD分别为4526.79万、4229.22万和297.57万人年，标化DALY率、YLL率和YLD率分别为5872.58/10万、5523.42/10万和349.16/10万，与1990年相比，2010年心血管病的死亡数、DALY、YLL和YLD分别增加了44.72%，28.58%，27.80%和39.68%，而标化死亡率、DALY率、YLL率和YLD率分别下降了14.45%、21.01%、21.91%和6.66%。在1990和2010年，不同种类的心血管疾病中，脑血管病的DALY均为最高，分别为2487.68万和3013.89万人年，其次为缺血性心脏病（分别为1012.70万和1788.58万人年）；脑血管病的YLL亦为最高，分别为2434.36万和2917.26万人年，其次为缺血性心脏病（分别为899.15万和1608.39万人年）。脑血管病和缺血性心脏病的死亡数从1990年的134.06万例和45.03万例，分别增加到了2010年的172.67万例和94.87万例。脑血管病标化死亡率、DALY率分别从1990年的187.19/10万、3335.37/10万下降至2010年的141.43/10万和2409.09/10万，而缺血性心脏病的标化死亡率和DLAY率却分别从1990年的62.52/10万和1318.38/10万增加到2010年的77.89/10万和1428.31/10万。结论心血管病在中国导致的疾病负担越来越严重，其中以脑血管病和缺血性心脏病最为严重。

Objective To analyze the death status of disease burden of cardiovascular and circulatory diseases in 1990 and 2010 in China, and to provide the basic information for cardiovascular and circulatory disease prevention and control. Methods Using the results of the Global Burden of Diseases Study 2010（GBD 2010） to describe the cardiovascular and circulatory diseases deaths status and disease burden in China. The measurement index included the mortality, years of life lost due to premature mortality （YLL）, years lived with disability （YLD）, and disability-adjusted life years （DALY）. At the same time, we used the population from 2010 national census as standard population to calculate the age-standardized mortality rate and DALY rate, YLL rate and YLD rates which will describe the mortality status and disease burden of total and different types of cardiovascular disease. We also calculated the change in 1990 and 2010 for all indexes, to describe the change of the burden of disease in the 20 years. Results In 2010, the total deaths of cardiovascular and circulatory diseases reached 3.136 2 million, the mortality rate reached 233.70 per 100 000 people and the age-standardized mortality rate was 256.90 per 100 000 people. The total DALYs, YLLs, and YLDs of cardiovascular and circulatory diseases reached 58.2055, 54.0488, and 4.1568 million person-years, respectively, and the age-standardized DALY rate, YLL rate and YLD rate were 4 639.04, 4 313.13, 325.91 per 100 000. In 1990, the deaths only 2.1675 million and the DALYs, YLLs and YLDs were 45.2679, 42.2922, and 2.9757 million person-years. The age-standardized mortality rate was 300.30 per 100 000 people. And the age-standardized DALY rate, YLL rate and YLD rate were 5 872.58, 5 523.42 and 349.16 per 100 000. Compared with the result in 1990, the total deaths, DALYs, YLLs, and YLDs were increased 44.72%, 28.58%, 27.80%, and 39.68%, respectively, while the age-standardized mortality rate, age-standardized DALY rate, age-standardized YLL rate, and age-standardized YLD rate were decreased 14.45%, 21.01%, 21.91%, and 6.66%, respectively. In 1990 and 2010, cerebrovascular disease caused the most DALYs （24.8768 and 30.1389 million person-years, respectively） compared with other types of cardiovascular and circulatory diseases, and followed by ischemic heart disease （10.1270 and 17.8858 million person-years）. And the YLLs of cerebrovascular disease （24.3436 and 29.1726 million person-years） also the highest in different type of cardiovascular and circulatory diseases, ischemic heart disease （ 8.9919 and 16.0839 million person-years） was the second highest. The deaths of cerebrovascular disease and cerebrovascular disease increased from 1 340.6 and 450.3 thousands in 1990 to 1 726.7 and 948.7 thousands in 2010, respectively. The age-standardized mortality rate and DALY rate of cerebrovascular disease were decreased from 187.19 and 3 335.37 per 100 000 people in 1990 to 141.43 and 2 409.09 per 100 000 people. While in the ischemic heart disease, the age-standardized mortality rate, and DALY rate were increased form 62.53 and 1 318.38 per 100 000 people in 1990 to 77.89 and 1 428.31 per 100 000 people. Conclusion Burden of cardiovascular and circulatory disease became more and more serious in China, of which the cerebrovascular disease and ischemic heart disease were most serious.