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1990－2021年中国和全球阿片类药物使用障碍疾病负担及趋势分析

Disease burden of opioid use disorder in China and in the world, 1990 - 2021

    摘要
  • 摘要:
    目的  分析1990－2021年中国及全球阿片类药物使用障碍（OUD）的疾病负担，为公共卫生政策制定和疾病预防干预提供数据支持与科学依据。
    方法 基于全球疾病负担2021数据库，获取1990－2021年中国及全球OUD的发病率、患病率及伤残调整生命年（DALYs）率等数据。 采用Joinpoint回归模型分析疾病负担的平均年度变化百分比（AAPC），并结合社会人口指数（SDI）进行健康不平等分析及前沿分析。 通过分解分析，揭示人口增长、老龄化及流行病学因素对OUD疾病负担的影响。
    结果 1990－2021年，中国OUD的年龄标准化发病率（ASIR）、年龄标准化患病率（ASPR）及DALYs率（ASDR）均呈下降趋势，而全球范围内呈上升趋势。 中国ASIR从30.78/10万降至16.66/10万，ASPR从192.51/10万降至94.35/10万，ASDR从156.25/10万降至53.97/10万，AAPC分别为−2.05%、−2.36%和−3.39%；全球ASIR从23.37/10万增加至24.54/10万，ASPR从154.59/10万增加至198.49/10万，ASDR从103.69/10万增加至137.15/10万，AAPC分别为0.12%、0.81%和0.98%。 OUD负担在25～＜30岁人群中最高，男性显著高于女性。 SDI与OUD负担呈正相关，不同社会经济群体间的不平等增加，部分国家仍存在较大改善空间。 流行病学变化是中国OUD负担下降的主要原因，而人口增长是全球OUD负担加重的首要影响因素。
    结论 OUD是重大全球公共卫生挑战，其负担持续上升，中国OUD疾病负担呈现好转趋势，但整体负担水平依然较高。 制定全面公共卫生政策、针对性干预措施和有效治疗方案仍然是迫切的需求。

     

    Abstract:
    Objective  To analyzes the disease burden of opioid use disorder (OUD) in China and in the world from 1990 to 2021, and provide data support and evidence for public health policy development and disease intervention.
    Methods The data of the incidence, prevalence, and disability-adjusted life years (DALYs) of OUD in China and in the world from 1990 to 2021 were extracted from the Global Burden of Disease 2021 database. Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of the disease burden. Health inequality analysis and frontier analysis were conducted by using socio-demographic index (SDI). Decomposition analysis was performed to evaluate the impact of population growth, population aging, and epidemiological factors on the OUD burden.
    Results From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of OUD decreased from 30.78/100 000 to 16.66/100 000, from 192.51/100 000 to 94.35/100 000, and from 156.25/100 000 to 53.97/100 000, respectively in China with the AAPCs of −2.05, −2.36% and −3.39%, while the global rates increased from 23.37/100 000 to 24.54/100 000, from 154.59/100 000 to 198.49/100,000 and from 103.69/100 000 to 137.15/100 000, respectively, with the AAPCs of 0.12%, 0.81% and 0.98%. The OUD burden level peaked in individuals aged 25−<30 years, and it was significantly higher in men than in women. SDI showed a positive correlation with OUD burden, and the disease burden level varied across socioeconomic groups, and more efforts are needed to control OUD burden in some countries. Epidemiological changes were the main factors associated with the decline of OUD burden level in China, while population growth was the leading contributor to the global increase.
    Conclusion OUD remains a major global public health challenge due to the rising disease burden. Although China has seen improvements in OUD burden control, the overall burden level remains high. There is an urgent need to develop comprehensive prevention strategies, targeted interventions and effective treatment protocols.

     

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