1990~2019年中国颈脊髓损伤的流行病学调查

Epidemiological survey of cervical spinal cord injury in China from 1990 to 2019

中文关键词:  颈脊髓损伤  流行病学调查  2019年全球疾病、伤害和风险因素负担研究报告  发病率  患病率

英文关键词:Cervical spinal cord injury  Epidemiological survey  Global Burden of Diseases, Injuries, and Risk Factors Study 2019  Incidence  Prevalence

中文摘要:

  【摘要】 目的：研究1990~2019年中国颈脊髓损伤的发病率、患病率、致病原因、地域分布及年度变化趋势等流行病学特征。方法：采用全球疾病、伤害和风险因素负担研究报告（Global Burden of Diseases， Injuries， and Risk Factors Study，GBD）2019相关数据来计算中国整体颈脊髓损伤的发病率、患病率、年龄标化发病率和年龄标化患病率，采用中国疾病预防控制中心慢性非传染性疾病预防控制中心提供的不包含台湾地区在内的33个省级行政区数据（包括31个省/自治区/直辖市，香港和澳门特别行政区），对各行政区的颈脊髓损伤致病原因、地域分布及年度变化趋势等进行系统分析。结果：从1990~2019年，中国不包含台湾地区在内的33个省级行政区颈脊髓损伤患病人数从103.4万人增加到248.6万人，增加了140.51%，年龄标化患病率从0.09%增加至0.13%。1990年颈脊髓损伤的患病率在65~69岁达到峰值（男性50~54岁，女性75~79岁），而2019年在90~94岁年龄段达到峰值（男性65~69岁，女性85~89岁）。2019年，东部发达地区的年龄标化发病率和年龄标化患病率最高，如浙江分别为[11.44（7.34~17.48）/10万]和[212.00（196.52~229.10）/10万]，上海分别为[10.84（7.15~16.24）/10万]和[226.43（209.93-246.36）/10万]，江苏分别为[9.68（6.31~14.70）/10万]和[180.44（167.29~193.92）/10万]。此外，1990~2019年四川的年龄标化发病率和年龄标化患病率变化最大，变化值分别为[0.79（0.64~0.92）/10万]和[0.85（0.73~1.01）/10万]。2019年颈脊髓损伤的主要致病原因是跌倒和道路损伤，但各省级行政区的患病率和具体病因又各有不同。结论：1990~2019年间中国颈脊髓损伤的疾病负担明显加重，但因地域不同又有所差异。鉴于致病原因以跌倒和道路损伤为主，对发达地区和老年患者，应制定精准的预防和治疗策略，从而尽快控制和降低沉重的个人、家庭和社会负担。

英文摘要:

  【Abstract】 Objectives: To study the epidemiological features such as incidence, prevalence, etiology, geographical distribution and annual trends of cervical spinal cord injury(CSCI) in China from 1990 to 2019. Methods: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study(GBD) 2019 were used to estimate the incidence, prevalence, age-standardized incidence and age-standardized prevalence of CSCI in China. The data of 33 provincial-level administrative regions excluding Taiwan(including 31 provinces/autonomous regions/municipalities directly under the Central Government, Hong Kong and Macao Special Administrative Regions) provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention were used to systematically analyze the provincial etiology, geographical distribution and annual trends of CSCI. Results: From 1990 to 2019, the number of CSCI patients in China increased by 140.51%, from 1.034 million to 2.486 million, and the age-standardized prevalence increased from 0.09% to 0.13%. The prevalence of CSCI peaked at the age of 65-69 years old in 1990(male 50-54 years old, female 75-79 years old), and it peaked at 90-94 years old in 2019(male 65-69 years old, female 85-89 years old). In 2019, the age-standardized incidence and age-standardized prevalence rates were the highest in developed eastern provinces and cities, such as Zhejiang[11.44(7.34-17.48) per 100,000] and [212.00(196.52-229.10) per 100,000], Shanghai[10.84(7.15-16.24) per 100,000] and [226.43(209.93-246.36) per 100,000], and Jiangsu[9.68 (6.31-14.70) per 100,000] and [180.44(167.29-193.92) per 100,000]. In addition, the age-standardized incidence rate[0.79(0.64-0.92) per 100,000] and age-standardized prevalence rate[0.85(0.73-1.01) per 100,000] changed the most in Sichuan from 1990 to 2019. The main causes of CSCI in 2019 were low falls and road injuries, but the prevalence and specific causes varied by provinces. Conclusions: The disease burden of CSCI increased significantly in China in the past three decades, and it varied by regions. Given that falls and road injuries are the main causes of CSCI, precise prevention and treatment strategies should be formulated for patients in developed areas and elderly patients, so as to control and reduce the heavy burdens on individuals, families and society as soon as possible.