1990—2019年中国心肌炎疾病负担水平及其变化分析

Analysis of the change in disease burden of myocarditis in China from 1990 to 2019

目的分析1990—2019年中国心肌炎疾病负担水平及其变化趋势。方法依据全球疾病负担(global burden of disease,GBD)2019数据库,利用心肌炎发病率、死亡率、伤残调整寿命年(DALY)、伤残损失寿命年(YLD)、过早死亡损失寿命年(YLL)及其年龄标准化率和平均年度百分比变化率(AAPC)等指标比较分析1990—2019年我国和全球心肌炎水平,并阐述我国不同年龄、性别心肌炎疾病负担情况。结果与1990年相比,2019年中国心肌炎发病例数和死亡例数上涨幅度分别为47.47%和50.22%,DALY和YLL分别下降了25.59%、28.02%,而YLD上升了89.50%;2019年全球心肌炎的发病例数及死亡例数上升幅度分别为62.19%和65.40%,DALY和YLL分别下降了0.42%、2.53%,而YLD上升了64.21%。2019年,我国心肌炎的发病例数、死亡例数及DALY例数呈现双峰分布,均在小于20岁出现第一高峰。1990—2019年,我国心肌炎的标化发病率、标化死亡率及标化DALY率的AAPC分别为-0.223%(-0.233%,-0.213%)、-0.612%(-0.812%,-0.411%)和-1.759%(-1.909%,-1.609%),而全球则为-0.157%(-0.164%,-0.151%)、-0.257%(-0.395%,-0.117%)和-1.210%(-1.312%,-1.109%)。我国心肌炎的发病率、死亡率及DALY率表现为男性高于女性。结论相较于1990年,2019年我国心肌炎标化发病率、标化死亡率及标化DALY率均呈下降趋势,但对我国年轻人和老年群体仍有较大威胁,尤其是年轻男性和老年女性,应持续强化心肌炎的诊断流程及防治工作。

Objective To describe the disease burden level and changing trend of myocarditis in China from 1990 to 2019.Methods According to the global burden of disease(GBD)2019 database,the incidence,mortality,disability-adjusted life year(DALY),years lost due to disability(YLD),years of life lost due to premature death(YLL)and their age-standardized rate(ASR)and average annual percent change(AAPC)of myocarditis in China and the world from 1990 to 2019 were compared and analyzed,and the disease burden of myocarditis in different age and gender groups in China was expounded.Results Myocarditis incidence cases and deaths increased in China by 47.47%and 50.22%,respectively,compared to 1990,whereas DALY and YLL reduced by 25.59%and 28.02%,and YLD rose by 89.50%.Myocarditis incidence cases and mortality increased by 62.19%and 65.40%globally in 2019,DALY and YLL reduced by 0.42%and 2.53%,respectively,and YLD rose by 64.21%.Myocarditis incidence cases,mortality,and DALY cases all displayed a bimodal distribution in China in 2019 and peaked at ages under 20.In China,the AAPC for standardized incidence,mortality,and DALY rates were-0.223%(-0.233%,-0.213%),-0.612%(-0.812%,-0.411%),and-1.759%(-1.909%,-1.609%),respectively,from 1990 to 2019.The standardized incidence,standardized mortality and standardized DALY rate of global myocarditis AAPC were-0.157%(-0.164%,-0.151%),-0.257%(-0.395%,-0.117%)and-1.21%(-1.312%,-1.109%),respectively.In China,men experience more myocarditis incidence,death,and DALYs than women.Conclusion Compared with 1990,in 2019,the standardized incidence,standardized mortality and standardized DALY rate of myocarditis in China showed a downward trend,but there is still a greater threat to young people and the elderly,especially young men and elderly women.We should constantly strengthen the diagnosis and prevention of myocarditis.