Burden and changing trend of urolithiasis in China, 1990-2019: an analysis of the global burden of disease
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摘要: 目的 描述和分析1990—2019年中国居民尿路结石疾病负担变化趋势，为预防和诊治尿路结石提供参考。方法 基于2019年全球疾病负担数据，选取发病数、发病率、死亡数、死亡率、伤残调整生命年(disability-adjusted life years，DALYs)、伤残寿命年(years lived with disability，YLDs)、早死引起的生命损失年(years of life lost with premature death，YLLs)及DALYs率等指标，计算不同年份和不同性别之间的变化趋势，对尿路结石的疾病负担进行描述。结果 相对于1990年，2019年中国居民尿路结石年龄标准化发病率、年龄标准化死亡率和年龄标准化DALYs率分别下降44.8%、83.3%和68.6%；而2019年全球居民尿路结石年龄标准化发病率、年龄标准化死亡率和年龄标准化DALYs率分别下降17.8%、33.3%和36.7%。在中国，相对于1990年，2019年尿路结石年龄标准化发病率、年龄标准化死亡率和年龄标准化DALYs率男性分别下降48.2%、70.7%和66.9%，女性分别下降34.2%、78.4%和72.4%。结论 自1990年以来，我国尿路结石疾病负担逐渐减轻，但发病率仍处于较高水平，且男性在发病率、死亡率和DALYs率方面远高于女性，我们需要采取多方面的策略来解决尿石症的预防和治疗问题。Abstract: Objective To describe and analyze the trend of the disease burden of urolithiasis among Chinese residents from 1990 to 2019, in order to provide reference for the prevention, diagnosis and treatment of urolithiasis.Methods Based on the global burden of disease data in 2019, the number of cases, incidence rate, number of deaths, mortality rate, disability-adjusted life years(DALYs), years lived with disability(YLDs), years of life lost with premature death(YLLs) and other indicators were selected to calculate and analyze the change trend in different years and between different genders, so as to describe the burden of urolithiasis.Results Compared with 1990, the age-standardized incidence, age-standardized mortality and age-standardized DALYs rate of Chinese residents in 2019 decreased by 44.8%, 83.3% and 68.6%, respectively. In 2019, the global age-standardized incidence of urolithiasis, age-standardized mortality rate and age-standardized DALYs rate decreased by 17.8%, 33.3% and 36.7%, respectively. In China, compared with 1990, the age-standardized incidence of urolithiasis, age-standardized mortality rate and age-standardized DALYs rate in 2019 decreased by 48.2%, 70.7% and 66.9% in males and 34.2%, 78.4% and 72.4% in females, respectively.Conclusion Since 1990, the burden of urolithiasis has gradually decreased in China, but the incidence is still at a high level, and the morbidity, mortality and DALYs rate of men are much higher than that of women. Therefore, we need to adopt various strategies to solve the problem of prevention and treatment of urolithiasis.
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Key words:
- urolithiasis /
- disease burden /
- incidence /
- mortality /
- disability-adjusted life years
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表 1 1990年和2019年中国与全球尿路结石发病数、ASR及EAPC比较
地区 1990年 2019年 EAPC 人数(95% CI) ASR(95% CI) 人数(95% CI) ASR(95% CI) 发病人数 中国 16 460 438.1
(12 904 492.6~20 408 293.2)1 614.2
(1 262.3~2 011.5)17 684 919.0
(14 099 066.0~21 623 473.7)889.9
(717.0~1075.4)-2.80
(-3.07~-2.52)全球 77 775 757.4
(62 239 115.6~95 126 750.8)1 696.2
(1 358.1~2 078.1)115 552 140.0
(93 045 130.4~140 180 402.4)1 394.0
(1 126.4~1 688.2)-0.83
(-0.92~-0.74)死亡人数 中国 4 007.1
(1 812.5~5 056.7)0.6
(0.3~0.7)2 558.4
(1 733.7~3 547.8)0.1
(0.1~0.2)-5.10
(-5.4~-4.79)全球 11 338.0
(7 277.6~13 777.5)0.3
(0.2~0.4)13 278.9
(10 616~16 267.4)0.2
(0.1~0.2)-2.05
(-2.24~-1.86)
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表 2 1990年和2019年中国与全球尿路结石YLDs、YLLs、DALYs比较
地区 1990年 ASR(1990年) 2019年 ASR(2019年) EAPC YLDs 中国 45 194.0
(29 036.2~65 641.9)4.4
(2.8~6.4)49 390.3
(31 575.7~70 651.9)2.5
(1.6~3.5)-2.71
(-2.98~-2.44)全球 213 082.0
(137 555.7~304 059.7)4.6
(3.0~6.7)318 738.5
(205 560.1~451 100.8)3.8
(2.5~5.4)-0.80
(-0.88~-0.71)YLLs 中国 113 848.2
(49 778.9~142 914.5)12.5
(5.6~15.6)52 818.9
(36 191.0~72 952.4)2.8
(1.9~3.8)-5.66
(-5.98~-5.35)全球 303 649.1
(183 448.1~364 577.4)7.1
(4.4~8.6)285 570.5
(220 887.4~345 374.3)3.5
(2.7~4.3)-2.61
(-2.78~-2.43)DALYs 中国 159 042.1
(94 017.6~196 634)16.9
(10.0~20.7)102 209.2
(78 978.4~129 311.6)5.3
(4.1~6.7)-4.57
(-4.84~-4.31)全球 516 731.1
(374 132.9~635 717.3)11.7
(8.6~14.4)604 308.9
(477 353.5~745 193.9)7.4
(5.8~9)-1.77
(-1.91~-1.64)
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