Su Wanghong, Zhang Chenran, Xi Huijuan, Lv Jia, Li Shaoru, Xu Hongmei, Cheng Yue, Han Bei
School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, 710061, Shaanxi, China.
Sci Rep. 2025 Aug 4;15(1):28388. doi: 10.1038/s41598-025-13893-5.
Driven by rapid urbanization and economic growth, PM pollution has emerged as a pressing issue exacerbating the stroke burden, especially in developing nations such as China. As a preventable and measurable risk factor, the stroke burden attributable to ambient and household PM has not yet received adequate attention. The data were collected from Global Burden of Disease (GBD) database from 1990-2021.The disease burdens (death, DALYs, YLLs and YLDs) of three subtypes of stroke, including intracerebral hemorrhage (ICH), ischemic stroke (IS) and subarachnoid hemorrhage (SAH), attributable to ambient and household PM2.5 by gender and age groups were explored. Jointpoint regression was employed to calculate annual average percentage changes (AAPCs). And the disease burden was predicted by Bayesian age-period-cohort (BAPC) model. The death, DALY, and YLL number of ICH and IS attributable to both ambient and household PM were the main components of the total stroke burden globally and in China, with ICH being higher than IS. From 1990 to 2021, the overall number of stroke burdens was increased with increasing ambient PM exposure. The AAPC changes of ASDR, ASR and YLL standardized rates for ICH and IS in China peaked at ages of 55-59. The ASDRs of ICH and IS attributable to ambient PM were slowly increased in the next 25 years, approximately final doubling from 2021. The stable and increasing burden of stroke suggests that effective measures of ambient and household PM should be continuously strengthened by the Chinese and global governments jointly for specific populations, especially middle-aged and elderly people in China.
在快速城市化和经济增长的推动下，颗粒物污染已成为一个紧迫问题，加剧了中风负担，在中国等发展中国家尤为如此。作为一个可预防和可测量的风险因素，环境和家庭颗粒物导致的中风负担尚未得到充分关注。数据来自1990 - 2021年全球疾病负担（GBD）数据库。探讨了按性别和年龄组划分的环境和家庭细颗粒物（PM2.5）导致的三种中风亚型（包括脑出血（ICH）、缺血性中风（IS）和蛛网膜下腔出血（SAH））的疾病负担（死亡、伤残调整生命年、寿命损失年数和伤残损失健康生命年数）。采用Joinpoint回归计算年度平均百分比变化（AAPCs）。并通过贝叶斯年龄-时期-队列（BAPC）模型预测疾病负担。环境和家庭细颗粒物导致的脑出血和缺血性中风的死亡、伤残调整生命年和寿命损失年数是全球和中国中风总负担的主要组成部分，脑出血高于缺血性中风。1990年至2021年，随着环境细颗粒物暴露增加，中风负担总数总体上升。中国脑出血和缺血性中风的年龄标准化死亡率、发病率和寿命损失年数的AAPC变化在55 - 59岁时达到峰值。未来25年，环境细颗粒物导致的脑出血和缺血性中风的年龄标准化死亡率将缓慢上升，到2021年左右最终翻倍。中风负担的稳定增加表明，中国和全球政府应联合针对特定人群，特别是中国的中老年人，持续加强环境和家庭细颗粒物的有效防控措施。
