1990-2021中国归因于生活方式和代谢因素的缺血性心脏病疾病负担及变化趋势

摘要/Abstract

摘要： 目的研究基于2021年全球疾病负担（GBD 2021）数据,分析中国缺血性心脏病的风险因素流行病学趋势,为中国公共卫生防控策略提供循证依据。方法提取1990-2021年由生活方式和代谢因素导致的中国缺血性心脏病的死亡人数、残疾调整生命年（DALYs）、标化病死率（AMSR）、标化伤残调整生命年率（ASDR）数据,采用Joinpoint回归模型计算年度平均变化百分比（AAPC）评估时间趋势,并按年龄、性别分层进行差异性分析。结果中国归因于高血压的缺血性心脏病的ASMR、ASDR呈明显上升趋势,AAPC分别为1.069（95CI：0.765-1.373）、0.819（95CI：0.562-1.078）,差异有统计学意义（P<0.05）,成为第一位危险因素,而饮食风险导致的疾病负担虽然呈下降趋势,但仍为第二位原因;高体重指数导致的缺血性心脏病的ASMR和ASDR虽然不高,但增长速度却是最快的,AAPC分别为 2.946（95CI：2.652-3.242）、2.580（95CI：2.346-2.815）,差异有统计学意义（P<0.05）;男性患者中所有危险因素导致的ASMR均呈上升趋势,且上升速度均超过女性,女性患者烟草、饮食风险导致的ASMR明显下降,AAPC分别为0.954、0.703,差异有统计学意义（P<0.05）。从年龄层面分析,绝对负担在不同性别存在年龄差异性,但相对负担均随年龄增长而上升,并且随着年龄增长上升速度加快,尤其是高龄女性,90-94岁之后趋于平稳或下降,但归因于肾功能障碍的ASMR和ASDR仍表现为急剧增长。结论代谢风险已成为主要风险因素,其中高血压为疾病负担的第一位危险因素,高体重指数和高空腹血糖正成为中国缺血性心脏病负担增长的重要驱动因素,在今后的防控工作中应重点关注,男性及高龄人群尤其是高龄女性为高负担对象,对于超高龄人群肾功能损害应重点关注。

关键词: 中国缺血性心肌病, 病死率, 伤残调整生命年, 代谢因素, 生活方式

黄瑞霞, 张桂香. 1990-2021中国归因于生活方式和代谢因素的缺血性心脏病疾病负担及变化趋势[J]. 心血管病防治知识, 2026, 16(13): 50-57.

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