1990—2019年中国人群腰背痛及其危险因素疾病负担变化趋势

范转转; 李文婷; 王志勇

doi:10.16462/j.cnki.zhjbkz.2023.07.011

1990—2019年中国人群腰背痛及其危险因素疾病负担变化趋势

doi: 10.16462/j.cnki.zhjbkz.2023.07.011

1.
江苏省南京市疾病预防控制中心物资设备科，南京 210003
2.
江苏省南京市疾病预防控制中心中心办公室，南京 210003
3.
江苏省南京市疾病预防控制中心基本公共卫生科，南京 210003

基金项目:

南京市卫生科技发展专项资金 GBX21213

详细信息

通讯作者:
王志勇，E-mail: zeeyom@yahoo.cn

中图分类号: R681.5;R181
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- 被引次数: 0
出版历程
- 收稿日期: 2022-07-19
- 修回日期: 2023-01-29
- 网络出版日期: 2023-08-08
- 刊出日期: 2023-07-10

Change trend analysis of the disease burden of low back pain and its risk factors in China from 1990 to 2019

1.
Department of Materials and Equipment, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
2.
Department of Central Office, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
3.
Department of Basic Public Health Section, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China

Funds:

Nanjing Health Science and Technology Development Special GBX21213

More Information

Corresponding author: WANG Zhiyong, E-mail: zeeyom@yahoo.cn

摘要

摘要: 目的分析1990—2019年中国人群腰背痛及其危险因素疾病负担的变化趋势。方法利用2019年全球疾病负担研究开放数据, 选用发病人数与发病率、患病人数与患病率、伤残损失寿命年(years lived with disability, YLDs)与YLDs率、人群归因分值(population attributable fraction, PAF)等指标对1990—2019年中国人群腰背痛及其危险因素疾病负担的变化趋势进行分析。结果 1990—2019年中国人群腰背痛的发病人数与发病率、患病人数与患病率、YLDs与YLDs率分别增长20.85%、0.57%、21.30%、0.95%、20.83%、0.55%, 标化发病率、标化患病率、标化YLDs率分别下降28.15%、29.13%、28.97%;女性腰背痛的疾病负担高于男性, 且差距逐渐增大; ≥70岁组的疾病负担高于其他年龄组。与腰背痛相关的3种危险因素中, 归因于职业工效学因素的疾病负担下降17.98%, 归因于吸烟、高BMI的疾病负担分别增长35.80%、196.27%。结论腰背痛仍是造成中国人群伤残负担的主要原因, 中国未来减轻腰背痛疾病负担的形势十分严峻, 建议从相关危险因素出发对女性、高龄等重点人群采取针对性措施以降低腰背痛的疾病负担。
- 腰背痛 /
- 危险因素 /
- 疾病负担 /
- 变化趋势
Abstract: Objective This study aimed to analyze the changing trend in the disease burden of low back pain and its risk factors in Chinese residents from 1990 to 2019. Methods The data were extracted from the database of the Global Burden of Disease Study 2019.We used case numbers, incidence, prevalence, years lived with disability (YLDs), YLDs rate, and population attributable fraction (PAF) to describe the burden of low back pain and its risk factors, and the changes from 1990 to 2019. Results From 1990 to 2019, the number of incidence cases and incidence rate, the number of prevalence cases and prevalence rate, YLDs and YLDs rate of low back pain increased by 20.85%, 0.57%, 21.30%, 0.95%, 20.83% and 0.55%, respectively.However, the standardized incidence rate, standardized prevalence rate, and standardized YLDs rate decreased by 28.15%, 29.13%, and 28.97%, respectively.The disease burden was higher in females than males, with the difference gradually increasing.Additionally, the disease burden was highest in the 70-year-old age group.Among the three risk factors associated with low back pain (occupational ergonomics, smoking, and high BMI), the disease burden attributable to occupational ergonomics decreased by 17.98%, while the burden attributable to smoking and high BMI increased by 35.80% and 196.27%, respectively. Conclusions Low back pain continues to be a major cause of disability burden among the Chinese population, with the situation being especially serious.Interventions to control the prevalence of risk factors should be formulated, and further measures should be taken to reduce the disease burden of low back pain, particularly among women and older people.
- Low back pain /
- Risk factors /
- Disease burden /
- Change trends

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图 1 不同年龄组腰背痛危险因素的归因疾病负担

1. BMI: 体质指数。
2. A：1990年不同年龄组腰背痛危险因素归因YLDs分布情况；B：2019年不同年龄组腰背痛危险因素归因YLDs分布情况；C：1990年不同年龄组腰背痛危险因素归因YLDs率分布情况；D：2019年不同年龄组腰背痛危险因素归因YLDs率分布情况。

Figure 1. Attributed disease burden to risk factors of low back pain in different age groups

1. BMI: body mass index.
2. A: YLDs attribute to risk factors in 1990; B: YLDs attribute to risk factors in 2019; C: YLDS rate attribute to risk factors in 1990; D: YLDS rate attribute to risk factors in 2019.

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表 1 1990—2019年中国人群腰背痛的疾病负担及其变化趋势

Table 1. Disease burden and trend of low back pain in Chinese residents from 1990 to 2019

变量 Variable	男 Male	女 Female	合计 Total
发病人数 Numberof incidence cases
1990年/万人 1990 year/×10⁴	1 458.69	1 864.25	3 322.93
2019年/万人 2019 year/×10⁴	1 662.43	2 353.41	4 015.84
变化率/% Change rate/%	13.97	26.24	20.85
AAPC/%	0.46 ^①	0.81 ^①	0.68 ^①
发病率 Incidence rate
1990年/10万^-1 1990 year/100 000^-1	2 390.56	3 250.68	2 807.29
2019年/10万^-1 2019 year/100 000^-1	2 293.57	3 373.92	2 823.38
变化率/% Change rate/%	-4.06	3.79	0.57
AAPC/%	-0.14 ^①	0.13 ^①	0.04
标化发病率 Age-standardized incidence rate
1990年/10万^-1 1990 year/100 000^-1	2 738.75	3 621.49	3 174.26
2019年/10万^-1 2019 year/100 000^-1	1 941.68	2 611.58	2 280.67
变化率/% Change rate/%	-29.10	-27.89	-28.15
AAPC/%	-1.17 ^①	-1.12 ^①	-1.16 ^①
患病人数 Number of prevalence cases
1990/万人 1990/×10⁴	3 237.36	4 292.48	7 529.84
2019/万人 2019/×10⁴	3 756.75	5 377.19	9 133.94
变化率/% Change rate/%	16.04	25.27	21.30
AAPC/%	0.52 ^①	0.78 ^①	0.68 ^①
患病率 Prevalence rate
1990年/10万^-1 1990 year/100 000^-1	5 305.52	7 484.78	6 361.37
2019年/10万^-1 2019 year/100 000^-1	5 183.00	7 708.91	6 421.72
变化率/% Change rate/%	-2.31	2.99	0.95
AAPC/%	-0.08 ^①	0.10 ^①	0.04
标化患病率 Age-standardized prevalence rate
1990年/10万^-1 1990 year/100 000^-1	6 131.89	8 375.33	7 245.29
2019年/10万^-1 2019 year/100 000^-1	4 328.76	5 915.76	5 134.73
变化率/% Change rate/%	-29.41	-29.37	-29.13
AAPC/%	-1.18 ^①	-1.18 ^①	-1.21 ^①
YLDs
1990/万人年 1990/×10⁴	372.01	483.27	855.29
2019/万人年 2019/×10⁴	430.73	602.68	1 033.41
变化率/% Change rate/%	15.78	24.71	20.83
AAPC/%	0.51 ^①	0.77 ^①	0.67 ^①
YLDs率 YLDs rate
1990年/10万^-1 1990 year/100 000^-1	609.67	842.68	722.56
2019年/10万^-1 2019 year/100 000^-1	594.26	864.02	726.55
变化率/% Change rate/%	-2.53	2.53	0.55
AAPC/%	-0.08 ^①	0.09 ^①	0.04
标化YLDs率 Age-standardized YLDs rate
1990年/10万^-1 1990 year/100 000^-1	697.09	936.36	815.20
2019年/10万^-1 2019 year/100 000^-1	493.40	662.76	579.05
变化率/% Change rate/%	-29.22	-29.22	-28.97
AAPC/%	-1.18 ^①	-1.18 ^①	-1.20 ^①
注：AAPC, 平均年度变化百分比；YLDs, 伤残损失寿命年。 ① P＜0.05。 Note: AAPC, average annual percentage change; YLDs, years lived with disability. ① P＜0.05.

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表 2 1990—2019年中国不同年龄居民腰背痛的疾病负担及其变化趋势

Table 2. The trends of age-specific burden of low back pain in Chinese residents from 1990 to 2019

变量 Variable	1990年 1990 year	2019年 2019 year	变化率/% Change rate/%	AAPC/%
年龄组/岁 Age group/years
15~＜50
发病人数/万人 Number of incidence cases/×10⁴	1 773.64	1 529.82	-13.75	-0.53
发病率/10万^-1 Incidence rate/100 000^-1	2 653.31	2 122.62	-20.00	-0.79
患病人数/万人 Number of prevalence cases/×10⁴	4 040.75	3 484.00	-13.78	-0.51
患病率/10万^-1 Prevalence rate/100 000^-1	6 044.85	4 834.01	-20.03	-0.76
YLDs/万人年 YLDs/×10⁴ years	467.58	406.32	-13.10	-0.48
YLDs率/10万^-1 YLDs rate/100 000^-1	699.49	563.76	-19.40	-0.73
50~＜70
发病人数/万人 Number of incidence cases/×10⁴	1 000.42	1 642.55	64.19	1.74
发病率/10万^-1 Incidence rate/100 000^-1	6 494.05	4 452.77	-31.43	-1.29
患病人数/万人 Number of prevalence cases/×10⁴	2 316.47	3 781.62	63.25	1.73
患病率/10万^-1 Prevalence rate/100 000^-1	15 036.86	10 251.55	-31.82	-1.30
YLDs/万人年 YLDs/×10⁴ years	262.84	430.82	63.91	1.74
YLDs率/10万^-1 YLDs rate/100 000^-1	1 706.20	1 167.92	-31.55	-1.28
≥70
发病人数/万人 Number of incidence cases/×10⁴	358.05	712.38	98.96	2.41
发病率/10万^-1 Incidence rate/100 000^-1	9 358.78	6 598.22	-29.50	-1.21
患病人数/万人 Number of prevalence cases/×10⁴	871.01	1 662.65	90.89	2.27
患病率/10万^-1 Prevalence rate/100 000^-1	22 766.50	15 399.91	-32.36	-1.36
YLDs/万人年 YLDs/×10⁴ years	91.81	173.68	89.17	2.24
YLDs率/10万^-1 YLDs rate/100 000^-1	2 399.79	1 608.67	-32.97	-1.39
注：YLDs, 伤残损失寿命年; AAPC, 平均年度变化百分比。 Note: YLDs, years lived with disability; AAPC, average annual percentage change.

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表 3 1990—2019中国人群腰背痛危险因素的归因疾病负担

Table 3. Attributed disease burden to risk factors of low back pain in Chinese residents from 1990 to 2019

变量 Variable	YLDs/万人年 YLDs/×10⁴ year	PAF/%	YLDs率/10万^-1 YLDs rate/100 000^-1
男 Male
职业工效学因素 Occupational ergonomic factors
1990年 year	164.93	0.44	270.29
2019年 year	131.13	0.30	180.91
变化率/% Change rate/%	-20.49	-31.82	-33.07
吸烟 Smoking
1990年 year	115.57	0.31	189.40
2019年 year	148.43	0.34	204.79
变化率/% Change rate/%	28.43	9.68	8.13
高BMI High BMI
1990年 year	6.20	0.02	10.16
2019年 year	18.64	0.04	25.71
变化率/% Change rate/%	200.64	100.00	153.05
女 Female
职业工效学因素 Occupational ergonomic factors
1990年 year	183.75	0.38	320.40
2019年 year	154.86	0.26	222.01
变化率/% Change rate/%	-15.72	-31.58	-30.71
吸烟 Smoking
1990年 year	12.88	0.03	22.45
2019年 year	26.01	0.04	37.29
变化率/% Change rate/%	101.94	33.33	66.10
高BMI High BMI
1990年 year	9.35	0.02	16.31
2019年 year	27.43	0.05	39.33
变化率/% Change rate/%	193.37	150.00	141.14
合计 Total
职业工效学因素 Occupational ergonomic factors
1990年 year	348.67	0.41	294.57
2019年 year	285.99	0.28	201.07
变化率/% Change rate/%	-17.98	-31.71	-31.74
吸烟 Smoking
1990年 year	128.45	0.16	108.51
2019年 year	174.44	0.17	122.64
变化率/% Change rate/%	35.8	6.25	13.02
高BMI High BMI
1990年 year	15.55	0.02	13.14
2019年 year	46.07	0.04	32.39
变化率/% Change rate/%	196.27	100.00	1.46
注：YLDs, 伤残损失寿命年；PAF, 人群归因分值。 Note: YLDs, years lived with disability; PAF, population attributable fraction.

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