中国及其省份的癫痫负担，1990 年至 2019 年：来自 2019 年全球疾病负担研究的发现。
Burden of epilepsy in China and its provinces, 1990 to 2019: findings from the Global Burden of Disease Study 2019.
机构信息
National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China.
出版信息
Chin Med J (Engl). 2023 Feb 5;136(3):305-312. doi: 10.1097/CM9.0000000000002526.
BACKGROUND
Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces.
METHODS
We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019.
RESULTS
In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92-1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33-133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03-98.74%) and 35.72% (95% UI: 0.47-86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43-5.66]/100,000), Qinghai (1.80 [95% UI: 1.15-2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88-1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39-0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44-0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41-0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased.
CONCLUSIONS
The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.
背景
癫痫在全球疾病负担中占很大比例。然而，中国及其各省份癫痫的疾病负担情况知之甚少。
方法
我们评估了 1990 年至 2019 年期间中国及其省、市、自治区的癫痫负担。通过年龄、性别、年份和省份来衡量癫痫的发病率、患病率、死亡率、残疾生存年数、生命损失年数和残疾调整生命年数（DALYs）。我们使用社会人口学指数（SDI）来确定 1990 年至 2019 年期间癫痫省级发展水平与年龄标准化 DALY 率之间的关联。
结果
2019 年，癫痫导致 1367.51 千（95%不确定区间[UI]：979.92-1837.61 千）DALY，年龄标准化 DALY 率为 99.77（95% UI：71.33-133.52）/100,000。中国癫痫的年龄标准化发病率和患病率分别为 24.65/100,000 和 219.69/100,000，分别比 1990 年增加了 45.00%（95% UI：8.03-98.74%）和 35.72%（95% UI：0.47-86.19%）。1990 年至 2019 年期间，25 岁以下年龄组癫痫造成的 DALY 比例稳步下降。50 岁及以上人群癫痫造成的 DALY 比例从 1990 年的男性 9.45%和女性 10.22%分别上升到 2019 年的男性 29.01%和女性 32.72%。西藏（4.26[95% UI：1.43-5.66]/100,000）、青海（1.80[95% UI：1.15-2.36]/100,000）和云南（1.30[95% UI：0.88-1.62]/100,000）的年龄标准化死亡率最高，而广东（0.48[95% UI：0.39-0.64]/100,000）、浙江（0.56[95% UI：0.44-0.70]/100,000）和上海（0.57[95% UI：0.41-0.73]/100,000）的死亡率最低。全国及各省、市、自治区的年龄标准化 DALY 率普遍随 SDI 的增加而降低。
结论
中国癫痫的疾病负担仍然很重，特别是在西部省份。癫痫的发病率和患病率在 1990 年至 2019 年间有所增加，老年人的癫痫负担逐渐增加。本研究为中国不同地区的癫痫预防和护理提供了证据。
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