1990年与2013年中国人群暴力疾病负担分析

Disease burden caused by violence in the Chinese population, in 1990 and 2013

目的分析1990年与2013年中国人群暴力疾病负担及变化趋势。方法利用2013年全球疾病负担中国研究结果，采用死亡率、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）等指标，对中国人群暴力疾病负担情况进行描述，并与1990年相应指标进行对比，描述中国暴力疾病负担的变化情况。结果2013年中国人群暴力死亡2．05万人，死亡率为1．44／10万；暴力造成的DALY损失为108．3万人年，其中锐器伤暴力造成的DALY损失为47．50万人年，火器伤暴力造成的DALY损失为9．03万人年，其他原因暴力造成的DALY损失为51．60万人年。男性暴力造成的DALY损失高于女性。与1990年相比，暴力标化死亡率下降67．35％，暴力DALY绝对值下降68．07％，暴力年龄标化DALY率下降70．47％；分年龄组结果显示，青壮年和老年人群的暴力疾病负担最为严重，与1990年相比，2013年970岁老年人的DALY绝对值上升9．36％，其中锐器伤暴力DALY上升17．65％；暴力标化DALY率在各个年龄段均呈现下降趋势，下降幅度最大的是0～4岁，其中，锐器伤暴力DALY率在0～4岁年龄段下降幅度为75．1l％，火器伤暴力DALY率在0～4岁年龄段下降83．20％。结论现阶段暴力造成的疾病负担下降，男性人群疾病负担高于女性，老年人的暴力疾病负担出现上升，且以锐器伤暴力为主，须采取针对性的防控措施。

Objective To analyze the disease burden of violence in the Chinese population, in 1990 and 2013. Methods Indicators including mortality rate, years of life lost due to premature mortality （YLL）, years lived with disability （YLD）, and disability-adjusted of life years （DALY） related to violence, were extracted from the Global Burden of Disease 2013 and used to describe the burden of disease caused by violence in the Chinese population. Data related to corresponding parameters on disease burden of violence in 1990 and 2013 were described. Results In 2013, a total of 20 500 people died of violent events, with the death rate as 1.44 per 100 000, in China. DALY caused by violence was 1.08 million person years in 2013. DALY caused by sharp violence was 0.47 million person years, with 0.09 million person years lost due to firearm violence. Disease burden caused by violence appeared higher in males than in females. When comparing with data from the 1990s, reductions were seen by 67.35% on the standardized death rate of violence, by 68.07% on the DALY attributable to violence, and by 70.47% on the standardized DALY rate attributable to violence, respectively, in 2013. Disease burden of violence among young adults and elderly was among the highest. When comparing with data from the 1990, DALY in 2013 decreased among all the age groups except for the 70-year-old showed an increase of 9.36%. The standardized DALY rate in 2013 showed a declining trend in all the age groups, mostly in the 0-4-year-old group. The standardized DALY rates caused by sharp violence or firearm decreased by 75.11% and 83.20% in the 0-4-year-old group. Conclusion In recent years, the disease burden caused by violence showed a decreasing trend but appeared higher in males however with the increase of DALY in the elder population.