1990—2019年中国一氧化碳中毒疾病负担分析

Analysis of disease burden of carbon monoxide poisoning in China,1990-2019

目的了解1990—2019年中国一氧化碳(carbon monoxide,CO)中毒的疾病负担情况,为预防CO中毒提供依据。方法利用2019年全球疾病负担数据库,分析1990—2019年中国CO中毒在不同性别、不同年龄、不同国家间的发病、死亡及伤残调整寿命年(disability adjusted life year,DALY),并采用Joinpoint回归模型分析CO中毒的疾病负担变化趋势。结果2019年中国CO中毒发病人数(24.03万人)较1990年(21.17万人)升高13.51%,世标发病率(21.82/10万)较1990年(16.20/10万)升高34.69%;死亡人数(1.50万人)较1990年(1.27万人)升高18.11%,世标死亡率(0.93/10万)较1990年(1.18/10万)下降21.19%;DALY(57.79万人年)较1990年(74.76万人年)下降22.70%,DALY率(40.92/10万)较1990年(62.91/10万)下降34.95%。1990—2019年中国男性CO中毒的发病人数、死亡人数、DALY人数均多于女性,差异有统计学意义(t值分别为8.29、15.80和19.91,P<0.05)。2019年中国CO中毒世标发病率在40~79岁、世标死亡率在<60岁、世标DALY率在30~59岁人群水平较低,而世标发病率在80岁以后持续上升,世标死亡率和DALY率均在60岁以后快速上升,到85~90岁达到顶峰。1990—2019年中国CO中毒的发病率呈现升高趋势,死亡率和DALY率呈现下降趋势,平均年度变化百分比(average annual percent change,AAPC)分别为1.05%、-0.81%、-1.42%。1990—2019年中国CO中毒的世标发病率与全球其他国家相比处于较低水平,世标死亡率及世标DALY率与全球及其他国家相比呈现较高水平。结论1990—2019年中国CO中毒的发病率呈波动上升趋势,死亡率及DALY率呈波动下降趋势,男性以及≥60岁人群尤其是≥80岁高龄老人的疾病负担较重,今后应重点关注。

Objective To investigate the disease burden of carbon monoxide(CO)poisoning in China from 1990 to 2019,and to provide a basis for the prevention of CO poisoning.Methods Based on the 2019 Global Burden of Disease database,the incidence,mortality,and disability adjusted life year(DALY)of CO poisoning in China from 1990 to 2019 were analyzed by sex and age and compared with other countries.A Joinpoint regression model was used to analyze the trend of the disease burden of CO poisoning.Results In 2019,the number of new cases of CO poisoning in China was 240300,with an increase of 13.51% from 211700 cases in 1990.The standardized incidence rate by the world standard population was 21.82 per 100000,with an increase of 34.69% from 16.20 per 100000 in 1990.The number of deaths in 2019 was 15000,with an increase of 18.11% from 12700 deaths in 1990.The standardized mortality rate by the world standard population was 0.93 per 100000,with a decrease of 21.19% from 1.18 per 100000 in 1990.The DALY decreased by 22.70% from 747600 person-years in 1990 to 577900 person-years in 2019,and the DALY rate decreased by 34.95% from 62.91 per 100000 in 1990 to 40.92 per 100000 in 2019.From 1990 to 2019,the number of cases,deaths,and DALYs due to CO poisoning in China were all significantly higher in males than in females(t=8.29,15.80,19.91,P<0.05).In 2019,the standardized incidence rate of CO poisoning in China was low among people aged 40 to 79 years,and increased continually beyond 80-year-olds;the standardized mortality rate was low within 60-year-olds,and the standardized DALY rate was low among 30-to 59-year-olds,both of which rapidly increased beyond 60-year-olds and peaked among 85-to 90-year-olds.From 1990 to 2019,the incidence rate of CO poisoning in China showed an increasing trend,while the mortality rate and DALY rate showed a decreasing trend,with the annual average percent changes being 1.05%,-0.81%,and-1.42%,respectively.Compared with other countries,China had a lower standardized incidence rate and higher standardized mortality and standardized DALY rates of CO poisoning from 1990 to 2019.Conclusion From 1990 to 2019,CO poisoning in China showed a fluctuating upward trend in the incidence rate and a fluctuating downward trend in the mortality rate and DALY rate,with a heavy disease burden for males and people≥60 years old(especially≥80 years old),whom should be paid attention to in the future.