1990－2021年中国与全球人群冠心病所致心力衰竭疾病负担特征及预测研究

刘永莹; 王立杰

doi:10.3784/jbjc.202407290446

1990－2021年中国与全球人群冠心病所致心力衰竭疾病负担特征及预测研究

Prevalence and disease burden of heart failure by coronary heart disease during 1990−2021 and trend prediction in China and in the world

摘要

摘要:
目的对比分析中国与全球人群冠心病所致心力衰竭（心衰）的疾病负担特征及趋势，为更全面了解中国情况及制定针对性防控措施提供依据。
方法利用2021年全球疾病负担（GBD 2021）研究数据，对比描述中国与全球冠心病所致心衰的患病和伤残所致健康寿命损失年数（YLD），并通过Joinpoint模型计算平均年度变化百分比（AAPC），描述变化趋势。采用贝叶斯年龄–时期–队列模型预测2022—2035年冠心病所致心衰的年龄标准化患病率和YLD率。
结果 1990—2021年中国人群冠心病导致心衰的粗患病率和粗YLD率分别从1990年的86.17/10万和7.72/10万增长至2021年的322.42/10万和28.81/10万，增幅分别为274.17%和273.19%；中国人群粗患病率和粗YLD率的AAPC分别为4.43%［95%置信区间（CI）：4.23%～4.64%］和4.42%（95%CI：4.24%～4.61%），均明显高于全球。 1990—2021年中国人群冠心病导致心衰的标化患病率和标化YLD率分别从1990年的146.54/10万和13.03/10万增长至2021年的230.21/10万和20.54/10万，增幅分别为57.10%和57.64%；中国人群标化患病率和标化YLD率的AAPC分别为1.56%（95%CI：1.29%～1.82%）和1.56%（95%CI：1.28%～1.85%），均明显高于全球。中国女性的粗患病率、粗YLD率的增幅、AAPC均高于男性。无论是中国还是全球，粗患病率和粗YLD率最高的均为≥95岁年龄组。经预测，中国与全球冠心病所致心衰的标化患病率和标化YLD率到2035年均有所下降。
结论中国冠心病所致心衰的疾病负担仍较严峻，需要持续关注。尤其应重点关注女性与老年人群，应结合现状制定更具针对性的防控措施。

Abstract:
Objective To compare and analyze the characteristics and trends of the burden of heart failure caused by coronary heart disease (CHD) in China and in the world, and provide evidence for the development of targeted prevention and control measures.
Methods The Global Burden of Disease 2021 (GBD 2021) data were used to compare the years of health life lost due to disability (YLD) caused by CHD in China and in the world, and the average annual percentage change (AAPC) was calculated with Joinpoint model to describe the changing trend. A Bayesian age-time-cohort model was used to predict the age-standardized prevalence rate (ASPR) and YLD rate of CHD-induced heart failure from 2022 to 2035.
Results From 1990 to 2021, the crude prevalence rate and crude YLD rate of heart failure caused by CHD increased in China from 86.17/100 000 and 7.72/100 000 to 322.42/100 000 and 28.81/100 000, with an increase of 274.17% and 273.19%, respectively. The AAPC of crude prevalence and crude YLD rates were 4.43% 95% confidence interval (CI): 4.23%−4.64% and 4.42% (95%CI: 4.24%−4.61%), respectively, in China, which were significantly higher than those in the world. From 1990 to 2021, the standardized prevalence rate and standardized YLD rate of heart failure caused by CHD in the China increased from 146.54/100 000 and 13.03/100 000 to 230.21/100 000 and 20.54/100 000, with an increase of 57.10% and 57.64%, respectively. The AAPC of the standardized prevalence rate and the standardized YLD rate were 1.56% (95%CI: 1.29%−1.82%) and 1.56% (95%CI: 1.28%−1.85%), respectively, in China, which were significantly higher than those in the world. The increase of crude prevalence rate, crude YLD rate and AAPC were higher in women than in men in China. Both in China and in the world, the highest crude prevalence and YLD rates were observed in age group ≥95 years. It is predicted that the standardized prevalence and the standardized YLD rate of heart failure caused by CHD would decline by 2035 both in China and in the world.
Conclusion The disease burden of heart failure caused by CHD is still heavy in China, to which more attention needs to be paid, especially the disease burden in women and the elderly, and more specific prevention and control measures should be developed according to the current situation.

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