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1990—2021年中国15～39岁人群肝胆胰良性疾病负担变化趋势分析
DOI: 10.12449/JCH260119
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作者贡献声明：姜文凯负责设计论文框架，起草论文；孙会淇、冯俊豪、彭文瑞负责数据收集、统计学分析、绘制图表；何茹、田明负责论文修改；田明负责拟定写作思路，指导撰写文章并最后定稿。
Changing trend of benign hepatobiliary and pancreatic diseases among people aged 15—39 years in China in 1990—2021
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摘要:
目的 分析1990—2021年我国15～39岁人群肝胆胰良性疾病的发病、患病、死亡和伤残调整寿命年（DALY）变化趋势。 方法 基于全球疾病负担研究（GBD）2021年数据，获取我国15～39岁人群肝纤维化/慢性肝病、良性胆囊/胆道疾病与胰腺炎的流行病学数据，计算估计年度百分比变化（EAPC）评估发病率、患病率、死亡率和DALY的变化趋势。利用贝叶斯年龄-时期-队列模型预测2022—2030年的发病率和死亡率。 结果 2021年，我国15～39岁人群中肝胆胰良性疾病新发共10 448 778例，相比于1990年增加3.8%；患病数、死亡数和DALY数相比于1990年分别减少20.4%、59.6%和50.2%。2021年，我国15～39岁人群中肝纤维化/慢性肝病、良性胆囊/胆道疾病与胰腺炎的年龄标准化发病率分别为1 104.4/10万、1 045.05/10万和16.64/10万，年龄标准化患病率分别为20 592.37/10万、2 364.85/10万和9.43/10万，年龄标准化死亡率分别为1.61/10万、0.04/10万和0.18/10万。1990—2021年，我国15～39岁人群中肝纤维化/慢性肝病的年龄标准化发病率（EAPC=0.43，95%CI： 0.23～0.63）呈上升趋势，良性胆囊胆道疾病的年龄标准化发病率（EAPC=1.07，95%CI： 0.91～1.24）和年龄标准化患病率（EAPC=0.75，95% CI：0.59～0.89）呈上升趋势；三类疾病的年龄标准化死亡率均呈下降趋势。预计2022—2030年，良性胆囊/胆道疾病发病率有所下降，胰腺炎发病率有所上升。 结论 我国15～39岁人群肝纤维化/慢性肝病与胆囊/胆道疾病发病率在过去30年间整体呈升高趋势，需进一步关注我国15～39岁人群的肝胆良性疾病的疾病负担。 Abstract:Objective To investigate the changing trends of the incidence rate， prevalence rate， mortality rate， and disability-adjusted life years （DALYs） of benign hepatobiliary and pancreatic diseases among people aged 15 — 39 years in China in 1990 — 2021. Methods The data of 2021 Global Burden of Disease Study were downloaded to obtain the epidemiological data of liver fibrosis/chronic liver disease， benign gallbladder/biliary tract diseases， and pancreatitis among people aged 15 — 39 years in China， and estimated annual percentage change （EAPC） was calculated to assess the changing trends of incidence， prevalence， mortality， and DALY rates. The Bayesian age-period-cohort model was used to predict the incidence and mortality rates from 2022 to 2030. Results In 2021， there were 10 448 778 new cases of benign hepatobiliary and pancreatic diseases among the individuals aged 15 — 39 years in China， which was increased by 3.8% compared with the data in 1990， while the numbers of prevalent cases， deaths， and DALYs were reduced by 20.4%， 59.6%， and 50.2%， respectively. In 2021， the age-standardized incidence rates of liver fibrosis/chronic liver disease， benign gallbladder/biliary tract diseases， and pancreatitis were 1 104.40/100 000， 1 045.05/100 000， and 16.64/100 000， respectively； the age-standardized prevalence rates were 20 592.37/100 000， 2 364.85/100 000， and 9.43/100 000， respectively； the age-standardized mortality rates were 1.61/100 000， 0.04/100 000， and 0.18/100 000， respectively. From 1990 to 2021， there was a tendency of increase in the age-standardized incidence rate of liver fibrosis/chronic liver disease （EAPC=0.43， 95% confidence interval ［CI］： 0.23 — 0.63）， and there was also a tendency of increase in the age-standardized incidence and prevalence rates of benign gallbladder/biliary tract diseases （incidence rate： EAPC=1.07， 95%CI： 0.91 — 1.24； prevalence rate： EAPC=0.75， 95%CI： 0.59 — 0.89）， while there was a tendency of reduction in the age-standardized mortality rate of all three disease categories. Predictions for 2022 — 2030 indicated a potential reduction in the incidence rate of benign gallbladder/biliary tract diseases and an increase in the incidence rate of pancreatitis. Conclusion There has been an overall upward trend in the incidence rate of liver fibrosis/chronic liver disease and gallbladder/biliary tract diseases over the past three decades， and it is needed to pay attention to the disease burden of benign hepatobiliary diseases among the people aged 15 — 39 years in China. -
Key words:
- Liver Diseases /
- Gallbladder Diseases /
- Biliary Tract Diseases /
- Pancreatitis /
- Global Burden of Disease
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注： ASIR，年龄标准化发病率；ASPR，年龄标准化患病率；ASMR，年龄标准化死亡率；DALY，伤残调整寿命年。
图 1 1990—2021年15～39岁人群肝胆胰良性疾病ASIR、ASPR、ASMR和年龄标准化DALY率变化趋势
Figure 1. The trends in the ASIR，ASPR，ASMR and age-standardized DALY rates of benign hepatobiliary and pancreatic diseases among people aged 15 to 39 years from 1990 to 2021
注： DALY，伤残调整寿命年。
图 2 不同年龄段人群2021年肝胆胰良性疾病的发病率、患病率、死亡率与DALY率
Figure 2. Incidence， prevalence， mortality and DALY rates of benign hepatobiliary and pancreatic diseases by age group in 2021
注： ASIR，年龄标准化发病率； ASMR，年龄标准化死亡率。
图 3 2022—2030年15～39岁人群肝胆胰良性疾病ASIR和ASMR预测趋势
Figure 3. Projected trends in the ASIR and ASMR of benign hepatobiliary and pancreatic diseases among people aged 15 to 39 years from 2022 to 2030
表 1 我国2021年15～39岁人群肝胆胰良性疾病的ASIR、ASPR、ASMR和年龄标准化DALY率
Table 1. Age-standardized incidence， prevalence， mortality and DALY rates of benign hepatobiliary and pancreatic diseases among people aged 15 to 39 years in China， 2021
疾病 ASIR（/10万） ASPR（/10万） ASMR（/10万） 年龄标准化DALY率（/10万） 肝纤维化/慢性肝病 总体 1 104.40 20 592.37 1.61 94.16 男性 1 149.81 22 087.22 2.69 155.98 女性 1 051.16 18 946.28 0.44 27.91 良性胆囊/胆道疾病 总体 1 045.05 2 364.85 0.04 54.95 男性 600.17 1 551.03 0.05 37.48 女性 1 530.86 3 250.72 0.03 73.98 胰腺炎 总体 16.64 9.43 0.18 11.41 男性 21.91 11.45 0.25 15.96 女性 10.98 7.26 0.09 6.49 
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