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1992—2021年中国居民肠梗阻发病趋势年龄–时期–队列分析

Age-period-cohort analysis of intestinal obstruction incidence trends among Chinese residents from 1992 to 2021

  • 摘要:
    目的 了解1992—2021年中国居民肠梗阻发病趋势,为制定精准的肠梗阻防控措施提供科学依据。
    方法 从2021全球疾病负担研究(GBD 2021)数据库中提取1992—2021年中国居民肠梗阻发病数、发病率和年龄标化发病率(ASIR)等相关数据,采用描述性分析和Joinpoint回归模型分析评价中国居民肠梗阻的发病率变化趋势并计算平均年度变化百分比(AAPC),应用年龄–时期–队列(APC)模型拟评估中国居民肠梗阻发病风险中的年龄效应、时期效应和队列效应。
    结果 中国总体居民、男性居民和女性居民肠梗阻发病率分别从1992年的204.411/10万、227.272/10万和179.973/10万上升至2021年的231.393/10万、259.508/10万和201.923/10万,ASIR分别从1992年的220.367/10万、247.453/10万和192.676/10万下降至2021年的198.500/10万、226.548/10万和170.553/10万,ASIR的AAPC值分别为–0.355%、–0.302%和–0.410%(均P<0.01)。APC模型分析结果显示,中国总体居民、男性居民和女性居民肠梗阻发病率的年龄效应均随年龄增长呈总体上升趋势,年龄效应系数分别从0~4岁的0.126、0.103和0.183上升至≥95岁的0.413、0.725和0.453;中国总体居民、男性居民和女性居民肠梗阻发病率的时期效应均随时间推移呈总体下降趋势,时期效应系数分别从1992—1996年的1.000、1.008和0.993下降至2017—2021年的0.942、0.958和0.920;中国总体居民、男性居民和女性居民肠梗阻发病率的队列效应均呈先上升后下降趋势,其中总体居民队列效应系数从1897—1901年的0.591上升至1942—1946年的1.079而后下降至2017—2021年的0.718,男性居民队列效应系数从1897—1901年的0.640上升至1947—1951年的1.076而后下降至2017—2021年的0.716,女性居民队列效应系数从1897—1901年的0.638上升至1927—1931年的1.142而后下降至2017—2021年的0.706。
    结论 1992—2021年中国居民肠梗阻的ASIR总体呈下降趋势,但仍应加强男性和老年人群肠梗阻的防控工作。

     

    Abstract:
    Objective To understand the incidence trends of intestinal obstruction in Chinese residents from 1992 to 2021 and to provide a scientific basis for formulating precise prevention and control measures for intestinal obstruction.
    Methods Data on the number of cases, incidence rate, and age-standardized incidence rate (ASIR) of intestinal obstruction in Chinese residents from 1992 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analysis and Joinpoint regression models were used to evaluate the trends in the incidence of intestinal obstruction in Chinese residents and calculate the average annual percentage change (AAPC). The age-period-cohort (APC) model was used to assess the age, period, and cohort effects on the risk of intestinal obstruction in Chinese residents.
    Results The incidence rates of intestinal obstruction in the total population, male residents, and female residents of China increased from 204.411/100 000, 227.272/100 000, and 179.973/100 000 in 1992 to 231.393/100 000, 259.508/100 000, and 201.923/100 000 in 2021, respectively. The ASIR decreased from 220.367/100 000, 247.453/100 000, and 192.676/100 000 in 1992 to 198.500/100 000, 226.548/100 000, and 170.553/100 000 in 2021, respectively. The AAPC values of ASIR were –0.355%, –0.302%, and –0.410% (all P<0.01), respectively. The APC model analysis showed that the age effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall upward trend with increasing age. The age effect coefficients increased from 0.126, 0.103, and 0.183 for ages 0–4 years to 0.413, 0.725, and 0.453 for ages ≥95 years, respectively. The period effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall downward trend over time. The period effect coefficients decreased from 1.000, 1.008, and 0.993 for the period 1992–1996 to 0.942, 0.958, and 0.920 for the period 2017–2021, respectively. The cohort effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed a trend of first increasing and then decreasing. The cohort effect coefficients for the total population increased from 0.591 for the 1897–1901 cohort to 1.079 for the 1942–1946 cohort and then decreased to 0.718 for the 2017–2021 cohort. The cohort effect coefficients for male residents increased from 0.640 for the 1897–1901 cohort to 1.076 for the 1947–1951 cohort and then decreased to 0.716 for the 2017–2021 cohort. The cohort effect coefficients for female residents increased from 0.638 for the 1897–1901 cohort to 1.142 for the 1927–1931 cohort and then decreased to 0.706 for the 2017–2021 cohort.
    Conclusions The ASIR of intestinal obstruction in Chinese residents showed an overall downward trend from 1992 to 2021, but it is still necessary to strengthen the prevention and control of intestinal obstruction in male and elderly populations.

     

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