1990年和2010年中国3种细菌性脑膜炎疾病负担情况

Disease Burden of three kinds of bacterial meningitis in China,1990 and 2010

目的了解1990年和2010年中国人群3种细菌性脑膜炎的疾病负担。方法利用2010年全球疾病负担研究结果,采用发病数和发病率,死亡数和死亡率,DALY(伤残调整生命年)数和率,YLL(早死造成的生命损失年)数和率,YLD(伤残造成的生命损失年)数和率指标,描述1990年和2010年中国人群肺炎球菌感染、b型流感嗜血杆菌脑膜炎和脑膜炎球菌感染的疾病负担并进行分析。结果 2010年较1990年,我国3种细菌性脑膜炎的标化发病率降幅达50%左右,死亡率降低75%左右。5岁以下儿童,尤其是1岁以下婴儿细菌性脑膜炎的DALY率最高。2010年1岁以下婴儿b型流感嗜血杆菌脑膜炎DALY率为97.82年/10万,肺炎球菌感染为49.49年/10万,脑膜炎球菌感染为32.22年/10万。随年龄增长,DALY率下降明显,但70岁及以上各种细菌性脑膜炎的DALY率又小幅升高。总体来看,2010年肺炎球菌脑膜炎的疾病负担最重、b型嗜血杆菌脑膜炎次之,脑膜炎球菌感染最低。结论 2010年较1990年,我国3种细菌性脑膜炎疾病负担明显下降。5岁以下儿童,尤其是1岁以下婴儿是细菌性脑膜炎发病和死亡的高危人群。

Objective To analyze the disease burden of three kinds of bacterial meningitis in China in 1990 and2010. Methods Data of the Global Burden of Disease Study 2010（ GBD 2010） were used to demonstrate and analyze the disease burden of haemophilus influenzae type b meningitis,pneumococcal meningitis and meningococcal meningitis in China in 1990 and 2010,including indicators of incidence,mortality rates,years of life lost due to premature mortality（ YLL）,years lived with disability（ YLD）,disability-adjusted life years（ DALY）,and their rates. Results In 2010,the standardized incidence and mortality rates of three kinds of bacterial meningitis decreased by about 50% and 75% compared with 1990. Children aged 5 years,especially those aged 1 year,had the highest rate of DALY for bacterial meningitis. The rate of DALY was 97. 82 years / lakh for haemophilus influenzae type b meningitis,49. 49 years / lakh for pneumococcal meningitis was and 32. 22 years / lakh for meningococcal meningitis among children aged 1 year in 2010. The rate of DALY for all three kinds of bacterial meningitis decreased rapidly and retained at lowlevel in children aged 5 years,but increased slightly in people aged 70 years. In general,pneumococcal meningitis had the highest disease burden and meningococcal meningitis had lowest disease burden in 2010. Conclusion Compared with 1990,the burden of three kinds of bacterial meningitis declined obviously in 2010. Children aged 5 years,especially the infants,were at high risk for bacterial meningitis.