1990—2019年中国与全球风湿性心脏病疾病负担分析

Disease burden analysis on rheumatic heart disease in China and the world from 1990 to 2019

目的:探讨1990—2019年中国与全球风湿性心脏病(RHD)疾病负担变化趋势。方法:基于2019年全球疾病负担研究(GBD 2019)数据库公开数据,利用患病率、发病率、死亡率、伤残调整寿命年(DALYs)及其年龄标化率等指标对1990—2019年中国与全球RHD疾病负担进行分析。结果:与1990年数据相比,2019年中国RHD年龄标化患病率、发病率及死亡率分别下降了12.6%、19.2%和77.9%,全球RHD年龄标化患病率及发病率仍呈上涨趋势,而死亡率下降了56.2%。此外,2019年数据显示,中国及全球RHD女性患病率、发病率和DALYs率均高于男性,中国RHD患病人数及患病率均呈现出一致的年龄双高峰现象(30~34岁、45~49岁),全球RHD患病人数及患病率高峰为20~24(男性)和25~29岁(女性),RHD新发病例数在中国及全球均于10~14岁达到高峰。1990—2019年,中国及全球RHD年龄标化DALYs率均呈下降趋势,但我国DALYs负担仍较重。结论:1990—2019年,中国及全球RHD患病率、发病率及死亡率均有所下降,但总体来看RHD疾病负担仍然很重,患病个体依旧在增加,死亡负担和伤残负担依然居高不下。女性、青少年和中老年群体是疾病负担需要重点关注的人群。进一步加强RHD重点人群的管理,对降低RHD疾病负担至关重要。

Objective:To analyze the trend of disease burden of rheumatic heart disease(RHD)in China and the world from 1990 to 2019.Methods:The open data was obtained from the Global Burden of Dis⁃ease 2019(GBD 2019)database.The prevalence,morbidity,mortality,and disability⁃adjusted life years(DALYs)and their age⁃standardized rates were used to explore the disease burden of RHD in China and the world from 1990 to 2019.Results:Compared with those in year 1990,the age⁃stan⁃dardized prevalence,morbidity,and mortality of RHD in China decreased by 12.6%,19.2%,and 77.9%,respectively,in 2019,while the global age⁃standardized prevalence and morbidity of RHD re⁃mained on the rise and mortality decreased by 56.2%.In addition,the 2019 data showed that the prevalence,incidence,and DALYs of RHD in women were higher than those in men,both in China and globally.The number and prevalence of RHD in China showed a consistent double peak phenomenon(reaching peaks at 30⁃34 and 45⁃49 years old).And the global peaked at 20⁃24 years old(men)and 25⁃29 years old(women).The number of new cases of RHD peaked at 10⁃14 years old,no matter in China or globally.From 1990 to 2019,the age⁃standardized DALYs rate of RHD showed a down⁃ward trend,with a decrease of 78.3%and 53.1%in China and the world,respectively.However,the DALYs burden in China was still relatively high.Conclusion:From 1990 to 2019,the preva⁃lence,morbidity,and mortality of RHD in China and the world decreased,but the overall disease bur⁃den of RHD is still very heavy.The number of affected individuals is still increasing,and the burden of death and disability of RHD is still high.Women,adolescents,and middle⁃aged and elderly popula⁃tions are the populations that need to pay more attention about the disease burden of RHD.Further strengthening the prevention and control of susceptible populations is crucial to reducing the disease burden of RHD.