1.广州中医药大学第四临床医学院,广东 深圳 518000
2.深圳市龙华区人民医院中医科,广东 深圳 518000
3.深圳市中医院脾胃病科,广东 深圳 518000
4.广州中医药大学东莞医院针灸科,广东 东莞 523000
张维晴,第一作者,研究方向:针药结合治疗消化系统疾病,E-mail:623440527@qq.com
收稿:2026-06-12,
修回:2026-08-03,
录用:2026-08-26,
纸质出版:2026-09-20
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张维晴,梁艺钟,莫梅兰等.中国与全球溃疡性结肠炎疾病负担及趋势[J].中山大学学报(医学科学版),2026,47(05):857-867.
ZHANG Weiqing,LIANG Yizhong,MO Meilan,et al.Burden and Trends of Ulcerative Colitis in China and Worldwide[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(05):857-867.
张维晴,梁艺钟,莫梅兰等.中国与全球溃疡性结肠炎疾病负担及趋势[J].中山大学学报(医学科学版),2026,47(05):857-867. DOI: 10.11714/jsysu.med.YX20260085.
ZHANG Weiqing,LIANG Yizhong,MO Meilan,et al.Burden and Trends of Ulcerative Colitis in China and Worldwide[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(05):857-867. DOI: 10.11714/jsysu.med.YX20260085.
目的
2
基于全球疾病负担研究2023(GBD 2023)数据,评估1990—2023年中国与全球溃疡性结肠炎(UC)的发病、患病和伤残调整寿命年(DALY)负担及其变化,分析人口学驱动并预测未来趋势。
方法
2
从GBD 2023 Results Tool提取中国、全球及204个国家和地区的UC数据,获得年龄标准化发病率(ASIR)、年龄标准化患病率(ASPR)和年龄标准化DALY率(ASDR)及95%不确定区间(UI)。采用Joinpoint回归计算平均年度变化百分比(AAPC)及95%置信区间(CI);采用Spearman秩相关、不平等与前沿分析、Das Gupta分解和自回归积分滑动平均模型(ARIMA)分别评价与社会人口学指数(SDI)的相关性、国家间负担差异、人口学驱动及2024—2035年趋势。
结果
2
2023年中国ASIR、ASPR和ASDR分别为0.94/100 000、5.95/100 000和5.94/100 000,低于全球的2.87/100 000、28.48/100 000和13.82/100 000。1990—2023年,中国ASIR和ASPR上升,AAPC分别为2.720%(95% CI:2.133%~3.309%)和2.261%(95% CI:1.617%~2.908%);ASDR下降,AAPC为-3.056%(95% CI:-3.449%~-2.662%)。全球
ASIR轻度上升,ASPR和ASDR下降。2023年中国粗发病率、粗患病率和粗DALY率峰值分别位于50~54岁、60~64岁和≥95岁。ASIR和ASPR与SDI呈正相关(
r
s
=0.579 4和0.617 7,均
P
<0.001),ASDR与SDI的相关性无统计学意义(
r
s
=0.066 6,
P
=0.343)。分解分析显示,中国发病数和患病数增加主要由流行病学变化贡献,DALYs下降主要由年龄别率变化贡献;全球DALYs增加主要由人口增长和人口老龄化贡献。至2035年,中国ASIR、ASPR和ASDR预计分别为1.23/100 000、6.37/100 000和2.55/100 000。
结论
2
1990—2023年中国UC的发病和患病负担上升,年龄标准化健康损失负担下降,绝对量负担峰值总体向中老年年龄组迁移;预测结果显示上述变化方向可能延续。本研究结果可为UC长期管理和卫生资源配置提供参考。
Objective
2
To assess changes in the incidence, prevalence, and disability-adjusted life-year (DALY) burden of ulcerative colitis (UC) in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023), and to examine demographic drivers and future trends.
Methods
2
UC data for China, the world, and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR), with 95% uncertainty interval (UI), were obtained. Joinpoint regression was used to estimate average annual percent change (AAPC) and 95% confidence interval (CI). Spearman rank correlation, inequality and frontier analyses, Das Gupta decomposition, and autoregressive integrated moving average (ARIMA) models were used to assess associations with the sociodemographic index (SDI), cross-country burden disparities, demographic drivers, and trends from 2024 to 2035, respectively.
Results
2
In 2023, the ASIR, ASPR, and ASDR in China were 0.94, 5.95, and 5.94 per 100 000 population, respectively, lower than the corresponding global estimates of 2.87, 28.48, and 13.82 per 100 000 population. From 1990 to 2023, China’s ASIR and ASPR increased, with AAPCs of 2.720% (95% CI: 2.133%-3.309%) and 2.261% (95% CI: 1.617%-2.908%), where
as the ASDR decreased (AAPC=-3.056%, 95% CI: -3.449% to -2.662%). Globally, ASIR increased slightly, whereas ASPR and ASDR decreased. In China, the crude incidence, prevalence, and DALY rates peaked at ages 50-54 years, 60-64 years, and ≥95 years, respectively. ASIR and ASPR were positively correlated with SDI (
r
s
=0.5794 and 0.6177, both
P
<
0.001), whereas the correlation between ASDR and SDI was not statistically significant (
r
s
=0.0666,
P
=0.343). In China, epidemiological change contributed most to increases in incident and prevalent cases, and changes in age-specific rates contributed most to the decline in DALYs; globally, population growth and population aging contributed most to the increase in DALYs. By 2035, China’s ASIR, ASPR, and ASDR were projected to be 1.23, 6.37, and 2.55 per 100 000 population, respectively.
Conclusions
2
From 1990 to 2023, the age-standardized incidence and prevalence rates of UC increased in China, whereas the age-standardized DALY rate decreased, and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.
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