1990—2019年中国类风湿关节炎疾病负担分析

Disease burden of rheumatoid arthritis in China,1990-2019

目的分析1990—2019年我国RA疾病负担变化趋势,为制定有针对性的RA防治策略提供科学依据。方法基于2019年全球疾病负担研究(GBD 2019)数据,依据患病例数、发病例数,患病率、发病率、伤残调整寿命年(DALY)、DALY率描述1990年—2019年我国与全球RA疾病负担情况。采用Joinpoint模型分析我国与全球1990—2019年RA的年龄标化患病率、年龄标化发病率和年龄标化DALY率的平均年度变化百分比(AAPC),分析RA疾病负担的变化趋势。结果1990年—2019年我国与全球RA标化患病率总体均呈上升的趋势,我国RA年龄标化患病率平均每年上升0.18%,差异有统计学意义(t=7.34,P=0.025);全球平均每年上升0.27%,差异有统计学意义(t=6.64,P=0.013),1990—2019年我国标化发病率呈上升趋势平均每年上升0.08%,差异有统计学意义(t=7.54,P=0.032),而全球呈下降趋势,平均每年下降0.37%,差异有统计学意义(t=-5.64,P=0.001)。2019年我国RA患病例数、患病率分别为430.94万例和302.98/10万,发病例数、发病率分别为22.25万例和15.64/10万,DALY和DALY率分别为77.43万人年和54.44/10万。与1990年相比,2019年患病例数、患病率分别上升了114.17%和78.23%,发病例数、发病率分别上升了77.90%和48.05%,DALY和DALY率上升了109.05%和73.97%。1990—2019年女性患病率、发病率和DALY率均高于男性,患病率和DALY率均随年龄的增长呈上升趋势,在75岁及以上年龄组达最高。结论1990—2019年我国RA标化发病率上升幅度高于全球,且我国发病、患病情况总体均呈上升趋势。我国RA患病、发病以及DALY情况均存在人群差异,女性和中老年人群为高危人群。

Objective To analyze the trend of disease burden of rheumatoid arthritis in China from 1990 to 2019,and to provide scientific basis for formulating targeted prevention and treatment strategies of rheumatoid arthritis.Methods Based on data of the global burden of disease study 2019(GBD 2019),according to the number of people with the disease,the prevalence,incidence,disability adjusted life year(DALY)and DALY rate of RA were used to describe the disease burden of RA in China and the world from 1990 to 2019.Joinpoint model was used to analyze the average annual percentage change(AAPC)of age-standardized prevalence rate,age-standardized incidence rate and age-standardized DALY rate of RA in China and the world from 1990 to 2019.The trend of disease burden of RA was analyzed.Results In general,the standardized prevalence of RA in China and the world showed an upward trend from 1990 to 2019,and the age-standardized prevalence of RA in China increased by 0.18%per year on average(t=7.34,P=0.025).The global average annual increase was 0.27%,with a statistically significant difference(t=6.64,P=0.013).From 1990 to 2019,the standardized incidence rate in China showed an average annual increase of 0.08%(t=7.54,P=0.032),while the standardized incidence rate in the world showed an average annual decrease of 0.37%(t=-5.64,P=0.001).In 2019,the number of patients and prevalence of RA in China were 4.309.4 million and 302.98/100000,respectively.The number of new cases and incidence of RA were 22.25 million and 15.64/100000,respectively.Compared with 1990,in 2019,the number of patients and prevalence rate increased by 114.17%and 78.23%,the number of new cases and incidence rate increased by 77.90%and 48.05%,and DALY rate increased by 109.05%and 73.97%,respectively.From 1990 to 2019,the prevalence rate,incidence rate and DALY rate of women were higher than those of men.Both the prevalence rate and DALY rate showed an increasing trend with age,with the highest in the age group of 75 years old and above.Conclusion From 1990 to 2019,the standardized incidence rate of RA in China has more increase than that in the world,and the overall incidence and prevalence of RA in China are on the rise.The prevalence,incidence and DALY of RA varies among different populations in China.Women and middle-aged and elderly people are at high risk.