1990—2019年中国归因于室外大气细颗粒物暴露的脑卒中疾病负担

Burden of disease for stroke attributable to ambient PM2.5 exposure in China 1990—2019

目的分析1990—2019年中国居民归因于室外大气细颗粒物(fine particulate matter,PM_(2.5))暴露的脑卒中疾病负担的变化趋势。方法利用2019年全球疾病负担研究(the global burden of disease study 2019,GBD 2019)中国部分数据,采用死亡数、死亡率、伤残调整生命年(disability adjusted life year,DALY)、DALY率及其年龄标化率和年度估计变化百分比(estimated annual percentage change,EAPC),分析1990—2019年中国归因于室外PM_(2.5)暴露的脑卒中疾病负担情况。结果2019年中国15岁及以上人群中,24.7%的脑卒中死亡是因暴露于室外PM_(2.5)导致的。与1990年相比,2019年中国归因于室外PM_(2.5)暴露的脑卒中死亡人数与死亡率分别增加至54.18万和39.08/10万,归因DALY和DALY率分别增加了2.07%和1.56%。男性死亡人数、死亡率、DALY和DALY率均高于女性,且随年龄的增长均呈上升趋势。中国归因年龄标化死亡率和DALY率高于全球及不同社会人口学指数(socio-demographic index,SDI)地区,且呈上升的趋势,EAPC分别为1.11(95%CI 0.47~1.75)、1.11(95%CI 0.53~1.69)。结论中国因暴露于室外PM_(2.5)的脑卒中疾病负担沉重,不同性别、年龄存在差异,且高于全球及不同SDI地区。

OBJECTIVE To analyze the trend of disease burden of stroke attributable to ambient PM_(2.5) exposure among Chinese residents from 1990 to 2019.METHODS On the basis of the data of global burden of disease study 2019(GBD 2019)in China,the burden of stroke attributable to the ambient PM_(2.5) exposure in China from 1990 to 2019 were analyzed using the number and rate of deaths,disability adjusted life year(DALY),DALY rate and its standardized rate and estimated annual percentage change(EAPC).RESULTS In 2019,24.7% of stroke deaths among people aged 15 years and above in China were due to ambient PM_(2.5) exposure.Compared with 1990,in China the number of stroke deaths and mortality attributable to ambient PM_(2.5) exposure increased to 541800 and 39.08/100000,respectively in 2019,and the attributable DALY and DALY rates increased by 2.07% and 1.56%,respectively,in 2019.And the attributable DALY and DALY in males were higher than those in females,and they were all increasing with aging.The attributed standardized mortality and DALY rates in China were higher than those of the global and different socio-demographic index(SDI)regions,and showed an increasing trend,with EAPCs of 1.11(95%CI 0.47-1.75)and 1.11(95%CI 0.53-1.69),respectively.CONCLUSION The burden of stroke disease due to ambient PM_(2.5) exposure is heavy in China,with differences in gender and age,and is higher than those of the global and different SDI regions.