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1990―2021年中国和全球运动神经元病的疾病负担及变化趋势

Burden and Trends of Motor Neuron Disease in China and Globally from 1990 to 2021

    摘要
  • 摘要:
    目的 分析1990—2021年中国及全球运动神经元病(motor neuron disease, MND)的疾病负担及变化趋势, 为我国制定相关卫生策略提供依据。
    方法 从2021年全球疾病负担(global burden of disease, GBD)数据库提取1990—2021年中国及全球MND的发病、患病、伤残调整生命年(disability-adjusted life years, DALYs)等疾病负担数据。采用Joinpoint模型通过平均年度变化百分比(average annual change percentage, AAPC)分析其变化趋势, 并从年龄和性别角度深入分析疾病负担差异。
    结果 1990—2021年, 中国MND发病例数增长了6.87%, 全球增长了74.54%。中国MND患病例数增长了29.78%, 全球增长了68.43%。中国MND的DALYs增长了40.08%, 全球增长了105.59%。中国和全球MND的年龄标化发病率(age-standardized incidence rate, ASIR)均呈下降趋势(中国: AAPC=-0.006, 95% CI: -0.006~-0.006, P＜0.001;全球: AAPC=-0.001, 95% CI: -0.001~ -0.001, P＜0.001)。中国MND的年龄标化患病率(age-standardized prevalence rate, ASPR)呈增长趋势(AAPC=0.006, 95% CI: 0.006~0.007, P＜0.001), 而全球变化不明显(AAPC=0, 95% CI: -0.001~0, P=0.082)。中国的年龄标化伤残调整生命年率(age-standardized disability-adjusted life year rate, ASDR)呈下降趋势(AAPC=-0.022, 95% CI: -0.033~-0.011, P＜0.001), 而全球呈上升趋势(AAPC=0.033, 95% CI: 0.028~0.039, P＜0.001)。此外, 中国男性绝大多数年龄段的MND疾病负担高于女性, 且45~74岁年龄段群体的MND疾病负担相对更重。
    结论 中国MND的总体疾病负担低于全球水平, ASIR和ASDR呈下降趋势, 但每年发病例数、患病例数以及DALYs仍呈增长趋势。此外, 中国MND疾病负担存在性别、年龄差异, 重点防控对象为中老年男性。

     

    Abstract:
    Objective To analyze the disease burden and trends of motor neuron disease(MND) in China and globally from 1990 to 2021, providing evidence for the formulation of relevant health strategies inChina.
    Methods Data on the incidence, prevalence, and disability-adjusted life years(DALYs) of MND in China and globally from 1990 to 2021 were extracted from the 2021 global burden of disease(GBD) database. The Joinpoint model was used to analyze trends through the average annual percentage change(AAPC). The disease burden differences were further analyzed by age and gender.
    Results From 1990 to 2021, the number of MND incident cases in China increased by 6.87%, while globally it increased by 74.54%.The number of prevalent cases in China rose by 29.78%, compared to a 68.43% increase globally. DALYs due to MND in China increased by 40.08%, while globally they increased by 105.59%. The age-standardized incidence rate(ASIR) of MND showed a declining trend both in China(AAPC=-0.006, 95% CI: -0.006 to -0.006, P < 0.001) and globally(AAPC=-0.001, 95% CI: -0.001 to -0.001, P < 0.001). The age-standardized prevalence rate(ASPR) in China showed an increasing trend(AAPC=0.006, 95% CI: 0.006 to 0.007, P < 0.001), while the global trend was not significant(AAPC=0, 95% CI: -0.001 to 0, P= 0.082). The age-standardized DALY rate(ASDR) in China showed a declining trend(AAPC=-0.022, 95% CI: -0.033 to -0.011, P < 0.001), whereas globally it showed an increasing trend(AAPC=0.033, 95% CI: 0.028 to 0.039, P < 0.001). Additionally, the MND disease burden was higher in males than in females across most age groups in China, with the burden being particularly heavy in the 45-74 age group.
    Conclusions The overall disease burden of MND in China is lower than the global level, with ASIR and ASDR showing a declining trend. However, the annual number of incident cases, prevalent cases, and DALYs continues to increase. Furthermore, there are gender and age differences in the MND disease burden in China, with middle-aged and elderly males being the key targets for prevention and control.

     

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