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中国全科医学

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1990—2021年中国类风湿性关节炎疾病负担变化趋势分析及预测研究

令垚，张文滨，王仕鸿，陈永泽，董文娇，邓星妤，丁元林*   

  1. 523808 广东省东莞市，广东医科大学公共卫生学院
  • 收稿日期:2024-06-07 接受日期:2024-07-29
  • 通讯作者: 丁元林，教授；E-mail：gdmusbd@gdmu.edu.cn
  • 基金资助:
    广东省基础与应用基础研究基金区域联合基金项目（重点项目）（2020B1515120021）；广东医科大学学科建设项目（4SG21276P）

Trend Analysis and Forecasting Study on the Changing Disease Burden of Rheumatoid Arthritis in China，1990-2021

LING Yao，ZHANG Wenbin，WANG Shihong，CHEN Yongze，DONG Wenjiao，DENG Xingyu，DING Yuanlin*   

  1. School of Public Health，Guangdong Medical University，Dongguan 523808，China
  • Received:2024-06-07 Accepted:2024-07-29
  • Contact: DING Yuanlin，Professor；E-mail：gdmusbd@gdmu.edu.cn

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摘要： 背景　类风湿性关节炎（RA）是一种常见的慢性自身免疫性疾病，其治疗和护理需要长期投入，包括药物治疗、手术治疗和康复治疗等，对患者家庭及社会都带来了较重的经济负担和社会负担，进行疾病负担的变化趋势及预测分析能为相关防治策略的制订提供参考。目的　了解1990—2021年中国RA疾病负担变化趋势，并预测2022—2042年中国RA的发病率、患病率和伤残调整寿命年（DALYs）率。方法　提取2021年全球疾病负担研究（GBD2021）1990—2021年有关RA的DALYs、发病和患病等疾病负担指标，采用SPSS27.0分别计算变化率和年估计变化百分比（EAPC）。采用自回归移动平均模型（ARIMA）对2022—2042年的发病率、患病率和DALYs率进行预测。结果　2021年中国RA的发病率、患病率和DALYs率分别为17.38/10万、334.25/10万、58.61/10万，较1990年分别增长了59.89%、92.61%、71.07%；1990—2021年中国RA的发病率、患病率和DALYs率均呈现上升趋势，EAPC分别为1.61%、2.33%、2.02%（P<0.05）。2021年中国女性RA的发病率、患病率和DALYs率（22.55/10万、460.19/10万、78.25/10万）均高于男性（12.45/10万、214.09/10万、39.87/10万）（P<0.05）。2021年中国RA的发病率在75~79岁达最高值（34.37/10万），患病率在≥80岁达最高值（836.13/10万），DALYs率在≥80岁达最高值（223.81/10万）。ARIMA模型结果显示，预计到2042年，中国RA的发病率、患病率、DALYs率分别为20.26/10万、468.60/10万、82.09/10万，较2022年分别上升了15.57%、37.94%和37.90%，且存在明显的性别和年龄差异。结论　1990—2021年中国RA的疾病负担增长趋势明显，具有年龄和性别差异。预计到2042年，RA的发病率、患病率和DALYs率将持续上升。提示相关部门应针对老年人、绝经期女性等重点人群实施相应的一级和二级预防措施。

关键词: 关节炎, 类风湿；全球疾病负担；伤残调整生命年；发病率；患病率；趋势分析；自回归移动平均模型

Abstract: Background　Rheumatoid arthritis（RA）is a common chronic autoimmune disease，the treatment and care of which requires long-term investment，including drug therapy，surgical treatment and rehabilitation，etc.，which imposes heavy economic and social burdens on the patient's family and the society，and an analysis of the trend of change in the burden of disease and the prediction of the burden of disease can provide references for the formulation of relevant prevention and treatment strategies. Objective　To understand the changes in the burden of disease of rheumatoid arthritis（RA）in China from 1990 to 2021 and to predict the incidence，prevalence，and disability adjusted life years（DALYs）rates of RA in China from 2022 to 2042. Methods　Burden of disease indicators such as DALYs，incidence and prevalence of RA from the Global Burden of DiseaseStudy 2021（GBD 2021）were extracted for the years 1990-2021，and the rate of change and estimated annual percentage change（EAPC）were calculated using SPSS 27.0，respectively. The autoregressive sliding average model（ARIMA）was used to project the incidence，prevalence and DALYs rates for 2022-2042. Results　In 2021，the incidence，prevalence and DALYs rate of RA in China were 17.38/100 000，334.25/100 000 and 58.61/100 000，respectively，which were 59.89%，92.61% and 71.07% higher than those in 1990，and the incidence，prevalence and DALYs rate of RA in China showed an increasing trend between 1990-2021，with an EAPC 1.61%，2.33% and 2.02%，respectively（P<0.05）. The rates of incidence，prevalence， and DALYs in women（22.55/100 000，460.19/100 000，and 78.25/100 000）were higher than those in men（12.45/100 000， 214.09/100 000，and 39.87/100 000）in 2021. In 2021，China's RA incidence reached its highest in the age group of 75-79 years（34.37/100 000），the prevalence in the 80 years old and above reached the highest（836.13/100 000），and the rate of DALYs was highest in the age group of 80 years old and above（223.81/100 000）. The results of the ARIMA model showed that the incidence rate of RA in China was projected to be 20.26/100 000，the prevalence rate to be 468.60/100 000，and the rate of DALYs to be 82.09/100 000 in 2042，in which the incidence rate had increased by 15.57%，the prevalence rate and the rate of DALYs had increased by 37.94% and 37.90% respectively from the 2022 level，and there were significant gender and age differences. Conclusion　There is a clear trend of increasing disease burden of rheumatoid arthritis in China from 1990 to 2021，with age and gender differences. Incidence，prevalence and DALYs due to rheumatoid arthritis are expected to continue to rise by 2042. This suggests that the relevant authorities in China should implement appropriate primary and secondary prevention measures for key populations such as the elderly and menopausal women.

Key words: Arthritis, rheumatoid；Global Burden of Disease；Disability adjusted life years；Incidence；Prevalence；Trend analysis；Autoregressive moving average mode

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