1990—2019年中国归因于固体燃料来源的家庭空气污染的心血管疾病负担分析

The burden of cardiovascular disease attributed to household air pollution from solid fuels in China from 1990 to 2019

目的 分析1990-2019年中国归因于固体燃料来源的家庭空气污染(HAP)的心血管疾病(CVD负担及其变化情况。方法 利用2019年全球疾病负担(GBD 2019)数据,采用死亡数、伤残调整寿命年(DALY)、年龄标化死亡率、年龄标化DALY率、年度变化百分比(APC)和平均年度百分比变化率(AAPC)等指标,对1990-2019年中国归因于HAP的CVD疾病负担及变化进行分析。结果 2019年,中国归因于HAP的CVD死亡数为22.70万例,DALY为518.22万人年,归因粗死亡率为15.96/10万,归因粗DALY率为364.34/10万。2019年,中国归因标化死亡率为12.52/10万,归因标化DALY率为262.65/10万,低于全球水平,且均表现为男性高于女性(13.90/10万vs. 11.32/10万、291.76/10万vs. 234.50/10万)。2019年,归因于HAP的CVD死亡率和DALY率均随着年龄的增长呈上升趋势,分别于95岁以上和85~89岁年龄段达到最高峰。1990-2019年,中国CVD的归因标化死亡率和标化DALY率均随年份变化呈下降趋势,AAPC分别为-6.0%[95%CI(-6.2%,-5.8%)]和-5.8%[95%CI(-6.1%,-5.6%)],其子类疾病负担也呈下降趋势。结论 1990-2019年,中国归因于固体燃料来源的HAP的CVD疾病负担呈明显下降趋势,且存在性别和年龄差异。男性和老年人群是该类疾病负担的重点人群,应采取有效措施进行干预。

Objective To analyze the burden of cardiovascular diseases(CVDs) and its trend attributed to household air pollution(HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019(GBD 2019), including mortality rates, disability-adjusted life years(DALY), agestandardized mortality rates, age-standardized DALY rates, annual percentage change(APC), and average annual percentage change rate(AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD;the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females(13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate(AAPC) of the age-standardized mortality rate was-6.0%(95%CI:-6.2% to-5.8%), and the APCC of the age-standardized DALY rate was-5.8%(95%CI:-6.1% to-5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend,with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.