1990—2019年中国类风湿性关节炎疾病负担现状和趋势分析

Current Status and Trend Analysis of Disease Burden of Rheumatoid Arthritis in China from 1990 to 2019

目的通过分析中国1990—2019年类风湿性关节炎(rheumatoid arthritis,RA)的疾病负担现状和变化趋势,为我国RA防控提供科学依据。方法从2019全球疾病负担(global burden of disease,GBD)数据获得1990—2019年RA的发病率、患病率、死亡率、伤残调整寿命年(disability adjusted life years,DALYs)等指标,通过四项指标的标化率对比分析中国、美国、日本及全球水平随年份发展的变化趋势。结果2019年,中国RA的发病率、患病率、死亡率、DALYs率及其标化率均为女性高于男性,死亡率随着年龄的增长呈上升的趋势,在95岁以上年龄组达到高峰;发病率、患病率及DALYs率随年龄的增长呈先上升后下降的趋势,分别在60~岁、70~岁、85~岁年龄段达到高峰。1990—2019年,中国RA的发病率、患病率、死亡率、DALYs率指标均呈上升趋势,消除人口年龄构成差异后,中国RA标化发病率和标化患病率呈上升的趋势;中国RA标化死亡率和标化DALYs率呈平稳趋势。2019年中国RA的标化发病率、标化患病率和标化DALYs率低于日本、美国和全球平均水平;2019年标化死亡率高于日本、美国和全球平均水平。结论在过去30年来,中国的RA疾病负担呈上升的趋势,应继续加强RA防控的宣传教育,尤其关注女性中老年人群的预防控制,制定合理政策,进一步减轻中国RA疾病负担。

Objective To provide a scientific basis for the prevention and control of rheumatoid arthritis(RA)in China by analyzing the current status and trend of disease burden in China from 1990 to 2019.Methods The incidence,prevalence,mortality,and disability adjusted life years of RA from 1990 to 2019 were analyzed based on GBD data.DALYs and other indicators,and comparative analysis of the annual development trend of the levels in China,the United States,Japan and the world through the scaling rates of the four indicators.Results In 2019,the incidence,prevalence,mortality,DALYs rate and standardized rate of RA in China were higher in females than in males,and the mortality rate increased with age,and peaked in the age group over 95 years old.The incidence rate,prevalence rate and DALYs rate increased firstly and then decreased with the increase of age,and reached the peak in age group 60~,70~and 85~years old,respectively.From 1990 to 2019,the incidence,prevalence,mortality and DALYs of RA in China showed an increasing trend.After eliminating the differences in population age composition,the standardized incidence and prevalence of RA in China showed an increasing trend.The normalized RA mortality rate and the normalized DALYs rate showed a steady trend in China.In 2019,the normalized incidence,prevalence and DALYs of RA in China were lower than those in Japan,the United States and the world.In 2019,the standardized mortality rate was higher than that of Japan,the United States and the world.Conclusion In the past 30 years,the disease burden of RA in China has been on the rise.It is necessary to strengthen the publicity and education of RA prevention and control,especially the prevention and control of middle-aged and elderly women,and formulate reasonable policies to further reduce the disease burden of RA in China.