刘炜炜, 胡跃华, 冯国双, 邵华, 刘世炜, 李镒冲, 么鸿雁, 周脉耕, 于石成. 1990-2010年中国病毒性肝炎的疾病负担及变化趋势[J]. 疾病监测, 2015, 30(8): 657-662. DOI: 10.3784/j.issn.1003-9961.2015.08.013
引用本文: 刘炜炜, 胡跃华, 冯国双, 邵华, 刘世炜, 李镒冲, 么鸿雁, 周脉耕, 于石成. 1990-2010年中国病毒性肝炎的疾病负担及变化趋势[J]. 疾病监测, 2015, 30(8): 657-662. DOI: 10.3784/j.issn.1003-9961.2015.08.013
LIU Wei-wei, HU Yue-hua, FENG Guo-shuang, SHAO Hua, LIU Shi-wei, LI Yi-chong, YAO Hong-yan, ZHOU Mai-geng, YU Shi-cheng. Burden of viral hepatitis in China, 1990-2010[J]. Disease Surveillance, 2015, 30(8): 657-662. DOI: 10.3784/j.issn.1003-9961.2015.08.013
Citation: LIU Wei-wei, HU Yue-hua, FENG Guo-shuang, SHAO Hua, LIU Shi-wei, LI Yi-chong, YAO Hong-yan, ZHOU Mai-geng, YU Shi-cheng. Burden of viral hepatitis in China, 1990-2010[J]. Disease Surveillance, 2015, 30(8): 657-662. DOI: 10.3784/j.issn.1003-9961.2015.08.013

1990-2010年中国病毒性肝炎的疾病负担及变化趋势

Burden of viral hepatitis in China, 1990-2010

  • 摘要: 目的 了解我国分性别、分年龄组甲、乙、丙、戊型病毒性肝炎的患病、死亡、疾病负担情况及20年的变化规律。 方法 利用2010年全球疾病负担研究(GBD 2010)中国病毒性肝炎结果,以2010年全国人口普查数据作为标准人口,对患病率、死亡率和疾病负担率指标进行标化;分性别、分年龄组对4种病毒性肝炎患病情况、死亡情况和疾病负担指标进行统计描述。 结果 中国1990年病毒性肝炎的患病数、标化患病率、死亡数、标化死亡率、伤残调整生命年 (disability-adjusted life years,DALY)、标化DALY率、早死造成的生命损失年(years of life lost,YLL)、标化YLL率、伤残损失的健康生命年(years lived with disability,YLD)和标化YLD率分别为5 912 987.44例、42 903.75/1000万、33 267.39例、348.06/1000万、1 480 678.28人年、13 841.84年/1000万、1 366 636.53人年、13 016.86年/1000万、114 041.75人年和825.15年/1000万,与之相比,2010年患病数、标化患病率、死亡数、YLD和标化YLD率增加,增幅分别为10.40%、10.09%、24.01%、8.12%和7.70%;标化死亡率、DALY、标化DALY率、YLL和标化YLL下降,减幅分别为2.37%、2.63%、25.34%、3.64%和28.26%。对于甲肝, 除15岁组患病数和YLD在20年间呈上升趋势外,其余各年龄组的所有指标呈下降趋势; 5岁组的儿童是甲肝高患病率和高DALY率人群,其值1990年分别为73 523.00/1000万和5023.00年/1000万,2010年分别为73 333.00/1000万和1935.00年/1000万。乙肝随年龄组增大患病率大致呈下降趋势,而死亡率大致呈上升趋势; 15~49岁组乙肝患病人数最多,患病率最低,50~69岁组DALY在20年间迅速上升,2010年为507 041.40人年,其值在各年龄组中最高。15~49 岁和50~69岁组是丙肝高患病和高负担人群,70岁组是其高死亡率人群,其值从1990年的33.40/1000万上升到2010年的52.80/1000万,增幅为36.74%。关于戊肝, 5岁和5~14岁组患病率和YLD率在过去20年呈上升趋势,其余各指标均呈下降趋势;50~69岁和70岁组各指标均呈上升趋势,其中50~69岁组患病率、死亡率和DALY的增幅分别为36.03%、20.10%和53.82%,70岁组分别为30.48%、31.96%和58.38%。 结论 按分性别、分年龄组描述患病、死亡和疾病负担更能准确地突出病毒性肝炎的防控重点,针对存在的主要问题,提出行之有效的策略措施。

     

    Abstract: Objective To understand the sex and age specific prevalence, mortality and burden of disease of viral hepatitis A, B, C and E in China during the past 20 years. Methods Descriptive analysis was conducted on the sex and age specific prevalence, mortality and other disease burden indicators of viral hepatitis A, B, C and E in China by using the data from China viral hepatitis survey in Global Burden of Disease Study 2010 (GBD 2010), which were standardized according to the standardized population data in China in 2010. Results In 1990, a total of 5 912 987.44 cases of viral hepatitis, including 33 267.39 deaths were reported in China with the standardized prevalence of 42 903.75/10 million and standardized mortality of 348.06/10 million, the disability-adjusted life years (DALY) and standardized DALY rate were 1 480 678.28 person-years and 13 841.84 person years /10 million respectively, the years of life lost due to premature mortality (YLL) and standardized YLL rate were 1 366 636.53 person years and 13 016.86 person years/10 million respectively, and the years lived with disability (YLD) and standardized YLD rate were 114 041.75 person years and 825.15 person years /10 million, respectively. In 2010, the cases, standardized prevalence, deaths, YLD, and standardized YLD rate increased by 10.40%, 10.09%, 24.01%, 8.12% and 7.70%; respectively, but standardized mortality, DALY, standardized DALY rate, YLL and standardized YLL rate declined by 2.37%, 2.63%, 25.34%, 3.64% and 28.26% respectively. For hepatitis A, except the increase of cases and YLD in the group 15 years, all the indicators showed a downward trend in all the other age groups during the past 20 years. The prevalence rate and DALY rate of hepatitis A were high in age group 5 years, which were 73 523.00 /10 million and 5023.00 person years /10 million in 1990 and 73 333.00 /10 million and 1935 person years /10 million in 2010. The prevalence of hepatitis B declined with age, but the mortality increased substantially. The case number of hepatitis B was highest in age group 15-49 years, but the prevalence was lowest. The DALY of hepatitis B in age group 50-69 years increased rapidly during the past 20 years, which was 507 041.40 person-year in 2010, highest in all age groups. The prevalence of hepatitis C was high in age groups 15-49 years and 50-69 years, and the mortality of hepatitis C was high in age group70 years, which increased from 33.40 /10 million in 1990 to 52.80 /10 million in 2010, an increase of 36.74%. For hepatitis E, the prevalence and YLD rate in age groups 5 years and 5-14 years increased during the past 20 years, but the other indicators declined. All the indicators of hepatitis E in age groups 50-69 years and 70 years showed an upward trend during the past 20 years, the prevalence, mortality and DALY increased by 36.03%, 20.10% and 53.82% respectively in age group 50-69 years and 30.48%, 31.96% and 58.38% respectively in age group of 70 years. Conclusion It is necessary to take effective measures for the prevention and control of viral hepatitis according to the sex and age specific prevalence and mortality of viral hepatitis.

     

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