Maracy Mohammad Reza, Isfahani Motahareh Tabar, Kelishadi Roya, Ghasemian Anoosheh, Sharifi Farshad, Shabani Reihaneh, Djalalinia Shirin, Majidi Somayye, Ansari Hossein, Asayesh Hamid, Qorbani Mostafa
Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2015 Nov;20(11):1077-83. doi: 10.4103/1735-1995.172832.
BACKGROUND: Cardiovascular diseases are viewed worldwide as one of the main causes of death. This study aims to report the burden of ischemic heart diseases (IHDs) in Iran by using data of the global burden of disease (GBD) study, 1990-2010. MATERIALS AND METHODS: The GBD study 2010 was a systematic effort to provide comprehensive data to calculate disability-adjusted life years (DALYs) for diseases and injuries in the world. Years of life lost (YLLs) due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm). Years lived with disability (YLDs) were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR). Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. RESULTS: The age-standardized IHDs DALY specified rate decreased 31.25% over 20 years from 1990 to 2010 [from 4720 (95% uncertainty interval (UI): 4,341-5,099) to 3,245 (95% UI: 2,810-3,529) person-years per 100,000]. The decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% [from 222) 95% UI: 207-243 (to 175 (95% UI:152-190) person-years per 100,000] in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. CONCLUSION: Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden.
背景：心血管疾病在全球范围内被视为主要死因之一。本研究旨在利用1990 - 2010年全球疾病负担（GBD）研究的数据，报告伊朗缺血性心脏病（IHD）的负担情况。 材料与方法：2010年GBD研究是一项系统性工作，旨在提供全面数据以计算全球疾病和损伤的伤残调整生命年（DALY）。因过早死亡导致的生命年损失（YLL）根据死因估计，使用死因汇总模型（CODEm）进行计算。伤残生存年（YLD）通过患病率、后遗症的伤残权重和症状持续时间相乘来评估。对已发表和未发表的数据进行系统回顾以评估疾病分布，随后使用贝叶斯元回归方法（DisMod-MR）计算患病率估计值。基于人群调查的数据用于生成伤残权重。通过蒙特卡罗模拟技术传播DALY计算中所有输入的不确定性。 结果：从1990年到2010年的20年间，年龄标准化的IHD DALY特定率下降了31.25%[从每10万人年4720（95%不确定区间（UI）：4341 - 5099）降至3245（95% UI：2810 - 3529）]。女性下降了38.14%，男性下降了26.87%。年龄标准化的IHD死亡特定率在两性中均下降了21.17%[从每10万人年222（95% UI：207 - 243）降至175（95% UI：152 - 190）]。在上述时期，年龄标准化的YLL率和YLD率分别下降了32.05%和4.28%。 结论：尽管从1990年到2010年年龄标准化的IHD死亡率、YLL、YLD和DALY率有所下降，但人口增长和老龄化增加了IHD的全球负担。自1990年以来，YLL的下降幅度超过了IHD死亡和YLD，但IHD死亡率仍然是疾病负担的最大贡献因素。
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