文献类型：期刊文献

中文题名：1990—2021年中国低温相关脑卒中疾病负担趋势分析及预测

英文题名：Trend analysis and forecast of disease burden of stroke due to cold weather in China,1990-2021

作者：张志东[1];蒋露[1];胡继宏[1,2,3];王莉[1];张荣华[1]

第一作者：张志东

机构：[1]甘肃中医药大学公共卫生学院,甘肃兰州730000;[2]甘肃中医药大学敦煌医学与转化教育部重点环境实验室,甘肃兰州730000;[3]甘肃中医药大学教学实验实训中心,甘肃兰州730000

第一机构：甘肃中医药大学公共卫生学院

年份：2025

卷号：42

期号：9

起止页码：1045

中文期刊名：环境与职业医学

外文期刊名：Journal of Environmental and Occupational Medicine

收录：;北大核心:【北大核心2023】；

基金：甘肃省联合科研基金一般项目(24JRRA880)。

语种：中文

中文关键词：脑卒中;疾病负担;低温环境;流行趋势;伤残调整寿命年

外文关键词：stroke;burden of disease;hypothermia;epidemiological trend;disability adjusted life year

摘要：[背景]研究提示极端气温会显著增加我国居民死于脑卒中的风险,其中低温环境对脑卒中疾病负担的影响远高于高温,分析和预测其流行现状能为脑卒中的防治提供一定参考。[目的]分析1990—2021年我国低温环境导致的脑卒中疾病负担变化情况。[方法]利用2021年全球疾病负担数据库(GBD2021)获取我国低温环境导致的脑卒中死亡和伤残调整寿命年(DALY)数据,应用Joinpoint回归模型分析低温环境导致的脑卒中归因死亡率和DALY率的平均年度变化百分比(AAPC)的变化趋势,采用年估计变化百分比(EAPC)描述1990—2021年归因低温死亡率和DALY率的性别、年龄分布,最后使用差分整合移动平均自回归模型(ARIMA)和贝叶斯模型(BAPC)预测2022—2036年我国低温环境导致的脑卒中归因标化死亡率(ASMR)和标化DALY率。[结果] 1990—2021年我国归因于低温环境脑卒中标化死亡率和标化DALY率整体呈下降趋势,AAPC分别为-2.07%和-2.36%,20岁以下的年龄人群标化死亡率和DALY率下降幅度最大,EAPC绝对值均大于3%,70岁以上的年龄人群粗死亡率和DALY率始终最高,2021年70岁以上人群粗死亡率大于50/10万,粗DALY率大于1 000/10万。所有年龄段和各年份中,我国男性低温环境导致的脑卒中疾病负担普遍高于女性,2021年我国男性归因标化死亡率和DALY率分别为14.55/10万和249.48/10万,均高于女性8.14/10万和137.87/10万。BAPC模型预测显示,2022—2036年我国低温环境导致的脑卒中归因死亡率和DALY率均呈下降趋势,其中我国男性的归因标化死亡率预计从2022年的14.62/10万降至2036年的11.42/10万,标化DALY率预计从265.25/10万下降至237.55/10万;女性的归因标化死亡率预计从2022年的8.06/10万降至5.68/10万,标化DALY率从138.92/10万降至109.34/10万,女性的下降趋势相较于男性更加明显,ARIMA模型的预测结果与BAPC模型一致,说明预测结果比较稳定。[结论] 1990—2021年我国不同年龄不同性别低温环境导致的脑卒中归因死亡率和DALY率均呈下降趋势,疾病负担有所减轻,但男性和老年人依旧是高风险人群,提示应重点关注高危人群,针对性地制定防控措施。
[Background]Research has indicated that extreme temperatures significantly increase stroke mortality risk among Chinese residents,with low temperatures exerting a substantially greater impact on stroke burden than high temperatures.Analyzing and predicting these patterns can inform stroke prevention and treatment strategies.[Objective]To analyze changes in stroke burden attributable to low-temperature environments in China between 1990 and 2021.[Methods]Using data from the Global Burden of Disease Study 2021(GBD2021),we estimated stroke mortality and disability adjusted life years(DALYs)attributable to low-temperature environments in China.Joinpoint regression modeling was applied to analyze trends by average annual percentage change(AAPC)of the attributable mortality rate and DALY rate.Estimated annual percentage change(EAPC)was used to describe gender and age distribution of these attributable low-temperature mortality and DALY rates between 1990 and 2021.Finally,autoregressive integrated moving average(ARIMA)modeling and Bayesian age-period-cohort(BAPC)modeling were used to predict attributable standardized mortality rate(ASMR)and standardized DALY rate associated with low-temperature environments in China from 2022 to 2036.[Results]From 1990 to 2021,the age-standardized mortality rate(ASMR)and age-standardized DALY rate(ASDR)for stroke attributable to low temperatures in China demonstrated an overall downward trend,with AAPCs of?2.07%and?2.36%,respectively.The ASMR and ASDR experienced the most significant reduction in the population under 20 years old,with absolute EAPC exceeding 3%.Conversely,the crude mortality rate and crude DALY rate remained consistently highest among those over 70 years old.In 2021,the crude mortality rate for this older age group exceeded 50 per 100000,and the crude DALY rate exceeded 1000 per 100000.Across all age groups and throughout the study period,the burden of stroke due to low temperatures was consistently higher among Chinese men compared to women.In 2021,the ASMR and ASDR attributable to low temperatures were 14.55 per 100000 and 249.48 per 100000 for men,respectively,significantly exceeding the rates for women(8.14 per 100000 and 137.87 per 100000).Projections from the BAPC model indicated that from 2022 to 2036,both the attributable mortality rate and DALY rate for stroke due to low temperatures in China were projected to continue declining.Specifically,the attributable ASMR for Chinese men was projected to decrease from 14.62 per 100000 in 2022 to 11.42 per 100000 in 2036,while the attributable ASDR from 265.25 per 100000 to 237.55 per 100000.For women,the attributable ASMR was projected to decrease from 8.06 per 100000 in 2022 to 5.68 per 100000 in 2036,and the attributable ASDR from 138.92 per 100000 to 109.34 per 100,000.This projected decline was more pronounced among women than among men.Furthermore,the prediction results from the ARIMA model aligned with those of the BAPC model,indicating relatively stable projections.[Conclusion]From 1990 to 2021 in China,the attributable mortality and DALY rates for stroke caused by low-temperature environments show a decreasing trend across different age groups and genders,indicating a reduction in the disease burden.However,males and the elderly remain high-risk groups.This suggests that focused interventions and targeted prevention and control measures should be prioritized for these high-risk populations.