Changing trend in disease burden of skin and subcutaneous diseases among Chinese residents, 1990 – 2019
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摘要:
目的 分析中国居民1990 — 2019年皮肤及皮下疾病疾病负担的变化趋势,为我国公共卫生政策的制定提供理论依据。 方法 收集2019年全球疾病负担(GBD 2019)研究中1990、2000、2010和2019年中国居民皮肤及皮下疾病疾病负担相关数据,采用发病数、标化发病率、患病数、标化患病率、伤残调整寿命年(DALY)、标化DALY率和估计年百分比变化(EAPC)等指标分析1990 — 2019年中国居民皮肤及皮下疾病疾病负担的变化趋势。 结果 中国居民1990 — 2019年皮肤及皮下疾病的发病数、标化发病率、患病数、标化患病率和DALY分别增长了29.33 %、27.20 %、27.23 %、5.52 %和14.75 %,但标化DALY率则降低了0.29 %;女性居民标化发病率低于同时期男性居民,但标化患病率和标化DALY率均高于同时期男性居民。中国居民1990 — 2019年皮肤及皮下疾病标化发病率增长最快的为褥疮(EAPC = 1.078,95 % UI = 0.826~1.317),下降最快的为蜂窝织炎(EAPC = – 1.210,95 % UI = – 1.416~– 1.019);标化患病率增长最快的为寻常痤疮(EAPC = 1.087,95 % UI = 1.052~1.110),下降最快的为蜂窝织炎(EAPC = – 1.097,95 % UI = – 1.289~– 0.917);标化DALY率增长最快的为褥疮(EAPC = 2.202,95 % UI = 0.905~3.451),下降最快的是蜂窝织炎(EAPC = – 7.304,95 % UI = – 8.081~– 7.087)。 结论 中国居民1990 — 2019年皮肤及皮下疾病的发病率和患病率有所增加,疾病负担虽有所改善但仍处于较高水平,其中对疾病负担增长最快的褥疮应加以重视。 Abstract:Objective To analyze changing trend in the burden of skin and subcutaneous diseases among Chinese residents during 1990 – 2019 for providing evidences to the development of health policy. Methods Data on incidence and prevalence of skin and subcutaneous diseases among Chinese residents in 1990, 2000, 2010, and 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Indicators including incidence and prevalence number, crude and standardized incidence and prevalence, disability-adjusted life years (DALY) and estimated annual percentage change (EAPC) of the indicators were adopted to assess changing trend in disease burden of skin and subcutaneous diseases. Results Compared to that in 1990, an upward trend in the burden of skin and subcutaneous diseases was observed among Chinese residents in 2019, with the increases of 29.33% for incidence number, 27.20% for age-standardized incidence rate, 27.23% for prevalence number, 5.52% for age-standardized prevalence rate, and 14.75% for DALY, respectively; but the age-standardized DALY rate decreased by 0.29%. During the period, the age-standardized prevalence rate and DALY rate of skin and subcutaneous diseases in female residents were higher than those in the male residents; while the age-standardized incidence rate for female residents was lower than that for male residents. In terms of different skin and subcutaneous diseases in Chinese residents during the 30-year period, decubitus ulcer showed the highest increase in age-standardized incidence rate (with an EAPC of 1.078, 95% uncertainty interval [95% UI]: 0.826 – 1.317) and in DALY rate (EAPC = 2.202, 95% UI: 0.905 – 3.451); in contrast, cellulitis manifested the highest decrease in age-standardized incidence rate (EAPC = – 1.210, 95% UI: – 1.416 – – 1.019) and in DALY rate (EAPC = – 7.304, 95% UI: – 8.081 – – 7.087); the increase of age-standardized prevalence rate was the highest for acne vulgaris (EAPC = 1.087, 95% UI = 1.052 – 1.110) but the decrease was the highest for cellulitis (EAPC = – 1.097, 95% UI: – 1.289 – – 0.917). Conclusion Among Chinese residents during 1990 – 2019, the burden of skin and subcutaneous diseases was under control but still remained at a high level due to increased incidence rate and prevalence rate of the diseases; special concern should be paid to decubitus ulcer to attenuate the burden of skin and subcutaneous diseases. -
Key words:
- skin and subcutaneous diseases /
- disease burden /
- changing trend /
- Chinese residents
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表 1 中国居民1990 — 2019年皮肤及皮下疾病的疾病负担
组别 年份 发病数(万例) 标化发病率(1/10万) 患病数(万例) 标化患病率(1/10万) DALY(万人年) 标化DALY率(1/10万) 例数 95 % UI 率 95 % UI 例数 95 % UI 率 95 % UI 人年数 95 % UI 率 95 % UI 男性 1990 31178.21 29685.66~32704.16 53149.19 50810.99~55589.81 14225.73 13786.46~14682.20 23664.94 22996.08~24369.20 345.52 229.51~513.62 572.48 383.73~841.47 2000 34597.20 32997.70~36319.85 53300.73 50950.91~55726.10 15799.04 1531372.09~16294.49 23997.29 23313.75~24716.34 371.29 244.53~551.76 565.90 373.58~840.33 2010 36890.39 35138.36~38645.48 53228.15 50846.44~55671.39 16816.85 16301.44~17320.77 24466.64 23773.59~25182.14 380.52 249.34~567.41 561.28 366.47~841.23 2019 39522.83 37578.64~41306.78 53614.37 51266.65~56003.68 17794.06 17257.37~18312.17 24932.63 24234.48~25646.29 391.04 256.19~581.91 563.28 364.81~848.85 女性 1990 29472.74 27950.79~30882.95 52787.29 50247.08~55202.64 14786.68 14339.43~15233.39 25796.77 25077.04~26543.28 374.72 245.26~548.02 646.15 426.18~943.77 2000 32914.28 31292.95~34445.97 52986.31 50483.86~55433.49 16597.84 16129.99~17078.57 26200.64 25476.85~26939.57 409.61 267.43~601.96 648.26 425.03~953.41 2010 35733.55 34010.83~37374.61 52980.64 50433.34~55382.60 17957.17 17471.07~18472.73 26732.36 25982.82~27507.87 425.12 276.08~625.40 647.53 419.98~959.02 2019 38916.70 36978.58~40703.09 53427.33 50871.86~55826.88 19118.68 18624.42~19620.08 27257.45 26500.62~28027.25 435.43 281.78~646.05 652.97 422.58~969.57 合计 1990 60650.96 57638.00~63452.76 52941.09 50579.14~55342.10 29012.41 28157.26~29883.60 24699.41 24027.60~25416.14 720.24 473.29~1061.26 608.09 402.95~895.59 2000 67511.48 64297.71~70703.74 53120.44 50743.81~55465.37 32396.88 31450.02~33352.68 25074.42 24370.61~25801.33 780.90 510.87~1156.78 606.12 397.39~897.85 2010 72623.95 69212.79~75931.56 53078.90 50702.81~55425.60 34774.02 33794.45~35752.19 25578.29 24865.99~26314.48 805.64 525.00~1200.65 603.20 392.39~902.24 2019 78439.53 74601.07~81916.75 53494.13 51104.14~55850.77 36912.74 35906.83~37916.04 26063.10 25348.68~26794.24 826.47 539.48~1235.63 606.34 391.32~909.27 表 2 中国居民1990 — 2019年各类皮肤及皮下疾病的发病情况及标化发病率变化趋势
疾病 1990 年 2019 年 EAPC 95 % UI 发病数
(万例)95 % UI 标化发病率
(1/10万)95 % UI 发病数
(万例)95 % UI 标化发病率
(1/10万)95 % UI 特应性皮炎 480.55 459.84~499.81 409.40 393.09~424.47 583.74 557.64~607.75 411.13 394.14~427.17 0.021 0.008~0.035 接触性皮炎 3997.88 3117.99~5009.33 3572.92 2802.47~4400.01 6382.75 4939.74~7915.65 3574.53 2803.81~4400.46 0.003 0.002~0.003 脂溢性皮炎 2142.69 1959.45~2320.60 1729.33 1591.34~1862.46 2524.52 2318.74~2732.14 1729.20 1590.59~1862.52 – 0.001 – 0.001~0.001 银屑病 78.46 75.61~81.30 68.25 65.84~70.70 89.29 85.96~92.43 53.96 52.08~55.79 – 0.798 – 0.816~ – 0.787 蜂窝织炎 123.61 113.03~133.53 109.05 100.29~117.61 122.13 113.24~131.40 84.00 77.42~90.31 – 1.210 – 1.416~ – 1.019 脓皮病 7289.03 7052.74~7564.61 6432.49 6227.48~6662.61 9075.17 8816.66~9390.87 6164.80 5987.81~6364.95 – 0.218 – 0.262~ – 0.175 疥疮 16272.87 14266.24~18512.25 13293.56 11750.64~14923.17 17087.90 15165.09~18923.15 12993.01 11497.41~14585.92 – 0.071 – 0.075~ – 0.068 真菌性皮肤病 15820.92 14187.66~17610.24 15048.94 13591.68~16668.85 23486.82 21074.62~26238.21 14576.78 13146.78~16228.96 – 0.127 – 0.134~ – 0.120 病毒性皮肤病 1842.73 1761.11~1925.66 1572.60 1503.02~1644.87 1714.48 1650.94~1779.36 1572.21 1502.72~1644.53 – 0.001 – 0.002~ – 0.001 寻常痤疮 1993.30 1771.88~2255.91 1555.71 1375.71~1775.96 2019.77 1814.68~2264.07 2086.69 1837.00~2382.25 1.032 1.006~1.049 斑秃 515.19 494.19~536.04 420.12 404.46~435.61 666.77 641.48~692.07 420.95 405.26~436.50 0.014 0.011~0.018 瘙痒 855.01 755.11~959.04 772.62 690.58~862.70 1389.90 1220.47~1562.22 844.73 752.85~942.07 0.316 0.304~0.327 荨麻疹 1585.76 1377.38~1828.43 1310.06 1148.61~1497.03 1693.07 1497.57~1888.73 1305.73 1145.17~1491.75 – 0.010 – 0.011~ – 0.009 褥疮 10.53 9.19~12.15 15.57 13.62~17.92 31.65 28.13~35.70 19.89 17.64~22.50 1.078 0.826~1.317 其他皮肤和皮下疾病 7642.43 7430.40~7850.91 6630.47 6461.67~6806.29 11571.56 11281.81~11875.83 7656.52 7461.73~7856.11 0.518 0.500~0.534 表 3 中国居民1990 — 2019年各类皮肤及皮下疾病的患病情况及标化患病率变化趋势
疾病 1990年 2019年 EAPC 95 % UI 患病数
(万例)95 % UI 标化患病率
(1/10万)95 % UI 患病数
(万)95 % UI 标化患病率
(万例)95 % UI 特应性皮炎 2831.90 2721.32~2933.90 2434.96 2342.91~2519.90 3558.37 3424.54~3694.20 2460.18 2366.59~2548.51 0.044 0.028~0.059 接触性皮炎 1457.54 1177.78~1823.50 1302.01 1053.90~1610.32 2311.29 1828.82~2877.94 1302.45 1054.20~1612.59 0.002 0.002~0.003 脂溢性皮炎 286.37 264.82~308.17 251.69 234.63~268.79 397.12 368.56~426.29 251.69 234.53~268.74 0.001 – 0.001~0.001 银屑病 633.55 610.31~656.05 577.92 556.62~597.26 765.33 738.58~790.83 434.82 420.27~448.33 – 0.985 – 1.012~ – 0.968 蜂窝织炎 7.57 6.99~8.16 6.62 6.15~7.12 7.59 7.04~8.17 5.27 4.89~5.67 – 1.097 – 1.289~ – 0.917 脓皮病 326.39 317.73~335.86 285.39 278.16~293.33 404.39 394.87~415.36 281.51 274.76~288.95 – 0.113 – 0.144~ – 0.082 疥疮 5375.92 4695.80~6134.53 4387.88 3877.53~4963.09 5672.90 5043.52~6328.60 4288.36 3791.61~4851.79 – 0.072 – 0.075~ – 0.068 真菌性皮肤病 4870.99 4318.43~5466.46 4600.81 4127.79~5138.03 7064.93 6288.79~7989.85 4425.21 3951.53~4965.78 – 0.155 – 0.164~ – 0.146 病毒性皮肤病 3276.43 3147.71~3392.30 2742.16 2638.85– 2840.66 3238.44 3125.09~3344.60 2747.47 2643.47~2845.76 0.008 0.006~0.009 寻常痤疮 4118.50 3695.97~4604.50 3037.89 2732.37~3380.82 4279.35 3910.17~678.42 4124.60 3713.35~4571.75 1.087 1.052~1.110 斑秃 290.35 278.71~302.44 237.95 228.94~246.97 380.44 366.07~394.63 238.47 229.46~247.57 0.015 0.011~0.018 瘙痒 1105.35 980.18~1256.82 1002.48 894.53~1127.87 1828.48 1609.62~2090.41 1104.61 984.92~1241.77 0.340 0.328~0.351 荨麻疹 898.65 777.73~1029.96 741.17 647.56~842.80 963.61 848.32~1077.12 738.71 645.58~839.90 – 0.010 – 0.011~ – 0.009 褥疮 2.82 2.46~3.25 4.15 3.61~4.75 8.36 7.44~9.41 5.25 4.68~5.94 1.034 0.785~1.273 其他皮肤和皮下疾病 7454.60 7249.66~7662.94 6464.28 6293.84~6638.44 11357.59 11064.67~11667.73 7461.97 7270.15~7661.12 0.517 0.499~0.533 表 4 中国居民1990 — 2019年各类皮肤及皮下疾病的DALY情况及标化DALY率变化趋势
疾病 1990 年 2019 年 EAPC 95 % UI DALY
(万人年)95 % UI 标化DALY率
(1/10万)95 % UI DALY
(万人年)95 % UI 标化DALY率
(1/10万)95 % UI 特应性皮炎 123.91 66.28~207.91 105.96 56.58~176.97 153.97 82.42~255.98 107.47 57.80~178.08 0.058 0.043~0.073 接触性皮炎 36.62 23.06~54.61 32.46 20.43~48.44 57.57 35.84~86.95 32.58 20.41~48.73 0.014 0.012~0.016 脂溢性皮炎 3.91 2.20~6.25 3.41 1.93~5.45 5.36 3.04~8.57 3.41 1.93~5.49 0.006 0.004~0.008 银屑病 55.59 39.62~74.23 50.26 35.93~66.97 66.27 47.19~87.58 37.93 26.94~49.94 – 0.973 – 1.000~ – 0.955 蜂窝织炎 5.61 2.39~8.65 5.39 2.47~7.92 1.26 0.97~1.85 0.85 0.65~1.23 – 7.304 – 8.081~ – 7.087 脓皮病 17.97 10.08~23.81 19.27 11.00~24.40 6.61 4.97~9.68 4.31 3.19~6.51 – 6.192 – 6.954~ – 5.831 疥疮 139.71 75.86~224.57 113.61 62.55~181.40 146.27 81.17~233.81 111.27 61.18~177.85 – 0.064 – 0.067~ – 0.060 真菌性皮肤病 27.44 10.94~59.64 25.63 10.38~55.88 39.26 15.82~85.47 24.68 9.94~53.96 – 0.152 – 0.160~ – 0.143 病毒性皮肤病 101.58 64.29~150.82 84.84 53.83~126.17 99.65 63.54~147.56 85.22 54.17~126.59 0.017 0.014~0.020 寻常痤疮 88.76 54.06~142.32 65.46 39.90~105.04 92.18 55.50~146.21 89.08 53.68~141.34 1.096 1.060~1.121 斑秃 9.57 6.01~14.29 7.82 4.91~11.66 12.48 7.88~18.53 7.86 4.92~11.71 0.027 0.022~0.032 瘙痒 11.81 5.65~21.11 10.63 5.11~18.98 19.35 9.16~34.76 11.74 5.58~21.07 0.348 0.336~0.359 荨麻疹 54.33 35.31~78.51 44.63 29.27~64.80 57.65 37.99~81.86 44.64 29.16~64.95 0.003 0.001~0.005 褥疮 1.13 0.87~1.80 2.00 1.58~3.17 4.91 3.94~5.87 3.16 2.53~3.75 2.202 0.905~3.451 其他皮肤和皮下疾病 42.32 20.43~77.34 36.72 17.91~66.64 63.68 31.02~115.08 42.11 20.57~76.48 0.402 0.339~0.464 -
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