1990-2017年中国创伤性脊髓损伤疾病负担特点分析

Characteristic analysis of disease burden of traumatic spinal cord injury in 1990-2017 in China

目的分析中国创伤性脊髓损伤(TSCI)疾病负担特点,为TSCI的防控提供科学依据。方法利用2017年全球疾病负担数据分析中国1990—2017年TSCI的发病、患病和伤残损失寿命年(YLD)率,并根据性别和年龄进行标化。分析TSCI疾病负担在28年间的变化情况。比较1990—2017年中国TSCI病因构成的变化。结果2017年中国TSCI发病数、患病数和YLD分别为13.43万、480.39万和132.13万;2017年中国TSCI发病率、患病率和YLD率分别为9.51/10万、340.10/10万和93.54/10万。男性TSCI的发病率、患病率及YLD率均高于女性。发病率15~49岁最高,患病率和YLD率在50~69岁最高。跌落的TSCI患者发病率、患病率及YLD率均高于其他类型病因。1990—2017年中国TSCI发病率、患病率及YLD率均呈上升趋势,且患病率增速最高。与1990年相比,2017年男性和女性TSCI发病率、患病率及YLD率均增长。TSCI患病率、YLD率的增幅均随年龄增长呈上升趋势,而发病率增幅随年龄呈不规律波动趋势。28年间TSCI发病患者的病因占比变化:跌落占比由1990年27.28%(20212/74085)升至2017年36.72%(49329/134339),道路交通伤害由1990年20.29%(15030/74085)增至2017年28.94%(38875/134339),自然灾害占比总体处于低发状态,但2008年猛增至16.03%(20059/125112)。结论1990—2017年中国TSCI发病率、患病率及YLD率均呈上升趋势,对我国人群健康的影响逐渐增大,需从公共卫生和重症救治的角度加以管控。28年间TSCI发病患者中女性、中老年和跌倒患者明显增多,提示应据人群特征和病因类型制订合理的防治方案。

Objective To analyze the characteristics of the disease burden of traumatic spinal cord injury(TSCI)in China so as to provide scientific evidences for the prevention and control of TSCI.Methods The CBD 2017 data was used to analyze the incidence,prevalence and years lived with disability(YLD)of TSCI in China from 1990 to 2017,and standardized by gender and age.The changes of TSCI burden within 28 years were analyzed.The changes in the etiology of TSCI in China from 1990 to.2017 were compared.Results In 2017,the incidence,prevalence and YLD of TSCI in China were.134300,4803900 and 1321300,respectively;the ineidence,prevalence and YLD rate of TSCI in China were 9.51 per 100000,340.10 per 100000 and 93.54 per 100000,respectively.The incidence,prevalence and YLD rate of TSCI in males were higher than these in females.The incidence rate was the highest at the age of 15-49 years.The prevalence and YLD rate were at the age of 50-69 years.The incidence,prevalence and YLD rate of TSCI due to falling were higher than other types of causes.From 1990 to 2017,the incidence,prevalence and YLD rate of TSCI in China showed an upward trend,and the increase rate in prevalence was the highest.Compared with 1990,the incidence,prevalence and YLD rate of TSCI in both males and females increased in 2017.The increase rate in prevalence and YLD rate of TSCI showed an upward trend with age,while the inerease in the incidence showed an irregular fluctuating trend with age.The proportion of causes of TSCI changed in a period of 28 years.The proportion of fall increased from 27.28%(20212/74085)in 1990 to 36.72%(49329/134339)in 2017,the proportion of road traffie aceidents increased from 20.29%(15030/74085)in 1990 to 28.94%(38875/134339)in 2017,and the proportion of natural disasters was generally low,but it soared to 16.03%(20059/125112)in 2008.Conclusion Within 28 years,TSCI has a higher incidence in female,middle-aged and elderly,and fall patients,suggesting reasonable prevention and treatment programs should be formulated according to population characteristics and etiological types.