2002年北京市居民心脑血管疾病的疾病负担分析

目的:计算5种心脑血管疾病的疾病负担,以评价心脑血管疾病对社会及人群所致危害程度的大小。方法:根据2002年北京市居民营养与健康状况调查中有关居民患病数据和北京市疾病预防控制中心统计信息中心死因统计数据资料,采用综合描述死亡与伤残负担的定量指标——伤残调整生命年(disability adhysted life year,DALY)作为反映疾病负担的量化指标。结果:2002年北京市居民心脑血管疾病的疾病负担中脑血管疾病造成的DALY损失最严重,平均每千人口造成15.77个DALY损失;男性脑血管病和心肌梗死的疾病负担高于女性;65岁以上老年人的心脑血管疾病负担高于中青年和青少年。结论:影响北京市居民健康的重点心脑血管疾病是脑血管病、急性心肌梗死、其他冠心病;重点人群是中老年人群。     

2010-2020年云南省德宏州红河州玉溪市艾滋病疾病负担分析北大核心CSCD

目的 以2010-2020年云南省艾滋病相对严重地区（德宏州和红河州）和一般地区（玉溪市）为例，探索建立艾滋病疾病负担分析方法并应用于艾滋病疫情评估中。方法 采用三个州市2010-2020年艾滋病病例报告数据和死亡数据资料分析疾病负担变化趋势，根据WHO设计的Excel计算模块测算伤残调整寿命年（DALY）、伤残损失健康寿命年（YLD）和过早死亡损失寿命年（YLL），分析艾滋病疾病负担趋势、年龄趋势和疾病负担构成。结果2010-2020年德宏州、红河州、玉溪市的DALY分别为22 912.80、74 555.07、5 306.40人年；三个州市艾滋病疾病负担均主要集中在青壮年，德宏州、红河州30～39年龄段人群疾病负担最高，玉溪市40～49年龄段人群疾病负担最高；2010-2020年三州市艾滋病疾病负担构成均以YLL为主，德宏州YLL占93.43%，红河州YLL占92.70%，玉溪市YLL占91.61%。结论 三州市艾滋病疾病负担总体呈先上升后下降的趋势，德宏州、红河州的疾病负担仍处于较高水平，三州市的YLL均占疾病负担的绝大部分，青壮年和老年人的疾病负担较为严重。     

1990-2017年中国艾滋病疾病负担分析

目的 分析1990-2017年中国艾滋病疾病负担变化.方法 利用全球疾病负担研究资料分析1990-2017年中国艾滋病疾病负担变化趋势;描述1990年和2017年死亡、伤残调整寿命年(DALY)、伤残损失健康寿命年(YLD)和过早死亡损失寿命年(YLL)的年龄、性别分布.结果 1990-2017年中国艾滋病年龄别标化死...     

广东惠州地区大肠癌疾病负担研究

目的 通过计算本地区大肠癌病人的疾病负担,了解本市不同性别、不同年龄段的大肠癌疾病负担及其变化趋势,进一步从社会经济角度认识和理解大肠癌.方法 应用伤残调整寿命年(DALY)、疾病死亡损失健康生命年(YLL)与疾病伤残损失健康生命年(YLD)等健康状况评价指标,对近5年来在本院就诊的大肠癌所造成的疾病负担进行测量和分析...     

认知障碍对老年人健康预期寿命的影响

目的研究认知障碍对北京市城乡≥60岁人群的预期寿命（LE）、健康预期寿命（ALE）及ALE/LE比值的影响。方法纳入的样本来自＂北京老龄化多维纵向研究＂课题,对象为宣武区（城区）、大兴区（近郊平原）、怀柔区（远郊山区）≥60岁老年人群。于2009年采用简易精神状态量表对2111人行认知功能的评估。2011年对该样本进行随访。根据能否独立完成日常生活活动（ADL）,评定健康与否。应用多状态寿命表IMaCH软件计算各年龄段认知障碍组与非认知障碍组的LE、ALE和ALE/LE比值。结果基线调查的2111人中认知障碍者有312例。①北京市老年人总体LE和ALE趋势为女性高于男性,城市高于农村。认知障碍组的LE和ALE均明显低于认知正常组。②认知障碍组中,城市低龄组（〈70岁）男性LE和ALE均明显低于同龄段女性。男、女,城、乡均为高龄组（≥80岁）的LE和ALE最低,但与认知正常组比较,城、乡均为女性的LE和ALE下降程度大于男性。③ALE/LE比值总体趋势为男性高于女性,城市高于农村。ALE/LE比值在两组均随年龄的增长而下降,但是认知障碍组的比值下降速度更快,尤其以农村高龄（≥80岁）女性ALE/LE比值最低。结论认知障碍对北京市老年人的LE、ALE、ALE/LE比值均有显著影响,特别是对农村高龄女性影响更显著。     

1990—2019年浙江省2型糖尿病疾病负担和危险因素变化趋势的研究

目的分析1990—2019年浙江省2型糖尿病(T2DM)疾病负担和危险因素的变化趋势。方法利用2019年全球疾病负担(GBD 2019)数据, 采用早死损失寿命年(YLL)率、伤残损失健康寿命年(YLD)率和伤残调整寿命年(DALY)率等指标评估疾病负担, 采用对数转换的线性回归模型描述和分析1990—2019年浙江省T2DM疾病负担和主要危险因素变化趋势, 同时与全国、世界不同社会人口学指数地区进行比较。结果 1990—2019年, 浙江省T2DM所致YLL率、YLD率和DALY率总体呈现上升趋势, 变化率分别为0.50%、2.53%和1.92%。2019年浙江省T2DM所致YLL率、YLD率和DALY率分别为152.90/10万、399.35/10万和552.25/10万, 其中70岁及以上人群组最高, 15～49岁组最低。2019年男性YLD率(403.30/10万)和DALY率(555.57/10万)高于女性(395.16/10万、548.74/万), 男性YLL率(152.26/10万)略低于女性(153.58/10万)。1990—2019年浙江省标化YLL率、YLD率和DA...     

1990年和2016年北京市心脑血管疾病负担及其变化

目的调查1990年和2016年北京市心脑血管疾病负担及其变化情况。方法利用2016年全球疾病负担研究数据,分析1990年和2016年北京市心脑血管疾病死亡情况和疾病负担。主要指标包括死亡人数、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD)和伤残调整寿命年(DALY),同时使用2000—2025年世界人口的平均人口作为标准人口,计算标化死亡率、DALY率、YLL率和YLD率。结果2016年,北京市居民心脑血管病标化死亡率为209.24/10万;心脑血管病DALY、YLL和YLD分别为87.56、73.36和14.20万人年,较1990年分别增加了58.05%、44.24%和213.47%;标化DALY率和标化YLL率分别为3552.24/10万和2988.01/10万,较1990年分别下降47.90%和52.43%,标化YLD率为564.23/10万,较1990年增加5.10%。2016年,脑血管疾病和缺血性心脏病的死亡数分别为1.76万例和2.37万例;DALY分别为39.63和39.36万人年,较1990年(DALY分别为33.02和16.27万人年)分别增加20.02%和141.92%。结论北京市心脑血管疾病负担重,其中以脑血管疾病和缺血性心脏病最为显著;脑血管疾病的伤残负担严重,缺血性心脏病的疾病负担成倍增长。     

2014年北京市居民心血管病死亡状况及寿命损失年分析

目的:分析2014年居民心血管病死亡负担,为北京市心血管病防控和管理提供依据。方法:应用2010年全球疾病负担的相关研究方法,估算2014年北京市户籍居民心血管病死亡状况和伤残损失寿命(YLL)。结果 :2014年北京市户籍居民心血管病死亡率为292.84/10万,标化死亡率为178.26/10万,占总死亡的46.95%(38 797/82 641)。心血管病YLL为317 812.67人年,每千人YLL为23.99人年,其中男性每年人YLL高于女性(30.59 vs.17.34人年)。从分病种来看,缺血性心脏病、缺血性脑卒中、出血性脑卒中高,分别为10.87、5.75和4.44人年;而高血压性心脏病、心肌病和心肌炎、风湿性心脏病低,分别为0.34、0.28和0.19人年。结论:2014年北京市户籍居民心血管病死亡负担重,且男性高于女性。     

脑血管疾病死亡对我国大陆居民期望寿命的影响

  目的 分析2005年和2010年脑血管疾病死亡对我国大陆居民期望寿命的影响程度,评价其对我国居民健康的危害。方法 采用经死亡漏报调整和城乡人口结构调整的中国疾病预防控制中心全国疾病死亡监测系统2005年和2010年的死亡数据,采用寿命表法计算期望寿命及各主要疾病去死因期望寿命,通过Arriaga法将去脑血管疾病死因增寿年数按各年龄组进行分解。结果2010年我国居民期望寿命为73.23岁,去脑血管疾病死因增寿年数为2.26岁,其中97%的去脑血管疾病死因增寿年数归因于＞40岁人群去脑血管疾病死亡。与2005年相比,2010年脑血管疾病死亡率有所降低,使居民期望寿命增加了0.04岁,占增寿年数的4%,但脑血管疾病死亡率降低城市明显大于农村,因此城市居民期望寿命增加了0.45岁,占总增寿年数的45%;而脑血管疾病死亡在农村居民中的增加使期望寿命降低了0.12岁,使农村居民期望寿命增幅降低了16%。结论 脑血管疾病死亡是影响我国居民期望寿命主要原因之一;脑血管疾病死亡对城乡居民期望寿命影响差异较大;降低脑血管疾病死亡、提高期望寿命的重点人群为农村＞40岁的居民。     

中国老年人群恶性肿瘤疾病负担

目的了解中国老年人恶性肿瘤发病、死亡情况及疾病负担。方法收集国家癌症登记中心发布的2006~2010年中国肿瘤登记年报数据,计算老年人发病率、死亡率、潜在减寿年(PYLL)、伤残调整生命年(DALY),比较老年人和中青年发病率、死亡率、每千人PYLL、每千人DALY。结果中国老年人恶性肿瘤发病率、死亡率为1 054.59/10万和786.53/10万分别是中青年(128.85/10万、58.14/10万)的8.18倍和13.53倍;老年人恶性肿瘤每千人PYLL(29.50年)和DALY(57.44年)分别是中青年(12.49年、11.82年)的2.36倍和4.86倍;男性老年人(34.80年,73.43年)每千人的PYLL和DALY分别明显高于女性(24.02年,41.95年);农村地区每千人PYLL和DALY(36.86年,66.64年)明显高于城市地区(26.51年,56.11年,均P<0.05)。结论中国老年人恶性肿瘤疾病负担严重,男性高于女性,农村高于城镇,应加强老年人肿瘤的综合防治研究,有效减轻老年人肿瘤疾病负担。     

Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004

The objective is to assess if longer life in Belgium is associated with more healthy years through the evaluation of trends (1997–2004) in health expectancy indicators at ages 65 and 80 covering different health domains: self-perceived health, chronic morbidity, disease clusters, and disability. Information was obtained from Belgian Health Interview Surveys. Health expectancies were calculated using the Sullivan method. Among males at age 65, the increase in years expected to live without chronic morbidity, without a disease cluster or without disability exceeded the increase of the life expectancy (LE). The rise in LE in good self-perceived health was equal to the gain in LE. Among women at age 65 and among men and women at age 80, none of the changes in the expected years of life in good health in any health domain were statistically significant. At age 65 among women, the increase in LE was smaller than the increase in years without chronic disease or without disability. The increase in years without disease clusters was less that the LE increase. At age 80 among men, the years without disability increased as the LE, with a shift toward years with moderate limitations. In any other health domains for men (except co-morbidity) and in all domains for women the years in good health either decreased or increased less than the LE. The recent rise in life expectancy in Belgium is, among the youngest old and especially among males, accompanied by an improved health status. At age 80 and particularly among women expansion of unhealthy years prevails.

Trends in disability-free life expectancy at age 65 in France: consistent and diverging patterns according to the underlying disability measure

Disability-free life expectancy estimates (DFLE) are summary measures to monitor whether a longer life expectancy (LE) is associated with better health or whether additional years of life are years of poor health or disability. Disability is a generic term defined as the impact of disease or injury on the functioning of individuals. It covers various situations from the rather common functional limitations to restrictions in daily activities and finally dependency. Disentangling these dimensions is essential to monitor future needs of care and assistance; but this is not always feasible since surveys do not systematically cover a large range of disability dimensions in their questionnaires. This study aims to cover different disability dimensions by using data from different French population surveys. We computed ten disability-free life expectancies, based on both specific and generic disability indicators from four population health surveys, in order to describe and compare trends and patterns for France over the 1980s and the 1990s. We used the Sullivan method to combine prevalence of disability and life tables. In 2000, two thirds of total LE at age 65 are years with physical or sensory functional limitations and 10% are years with restrictions in personal care activities. Trends in DFLE over the two last decades seem to have remained stable for moderate levels of disability and to have increased for more severe levels of disability or activity restrictions. We found that patterns are consistent from one survey to the other when comparing indicators reflecting similar disability situations.     

Premature death and disability profile in the population affiliated to the Mexican Institute of Social Security (IMSS)

OBJECTIVE: To carry out estimations of the burden of disease for 129 causes in order to identify health priorities in the different geographic regions of the country and to present comparative data between 1995 and 2000. MATERIAL AND METHODS: Indicators such as disability-adjusted life years (DALYs) and disability adjusted life expectancy (DALE) were analyzed for the population covered by IMSS in 1995 and 2000; for both years, the methodology proposed by the Burden of Disease Worldwide Study was applied. Data corresponding to 1995 were analyzed in 1997, while data corresponding to 2000 were analyzed in 2001. The comparative study was carried out in 2006 by IMSS, Mexico. RESULTS: The higher proportion of DALYs was due to chronic diseases, although the 2000 rate is 1.5 times higher than that of 1995. Priorities that were identified were diabetes mellitus, ischemic cardiopathy, and cerebrovascular disease, with a loss that is mainly accounted for by premature death, as well as by diseases related to disability with an important burden of disease, such as AIDS or depression. Epidemiological backlogs can still be observed. CONCLUSION: The population covered by IMSS is still in a phase of epidemiologic transition, favoring polarization in health conditions. Health policies need to be directed toward bringing about an improved response and reversing the trend in diseases that represent an institutional risk for the financing of health care.     

媒传疾病的疾病负担估算方法研究进展

媒传疾病的疾病负担是指媒传疾病所致患者伤残及早逝对健康寿命、社会经济造成的损失和影响,包括经济负担和个体家庭负担两个方面。伤残调整寿命年是衡量疾病负担的综合指标。疾病经济负担分为直接经济负担、间接经济负担和无形经济负担,直接经济负担的估算方法有微观成本法和宏观成本法,间接经济负担的估算方法包括人力资本法和摩擦成本法,无形经济负担一般用支付意愿法估算。目前卫生经济学评价方法主要是成本-效用分析、成本-效益分析和成本-效果分析法。本文对疟疾等媒传疾病的疾病负担估算方法进行综述,以比较不同方法对指标选择的要求及其应用价值。     

血吸虫病疾病负担的研究I慢性血吸虫病健康寿命损失年的计算与评价

目的探讨慢性血吸虫病疾病负担的评价指标及其计算方法。方法根据2004-2005年在湖区两县开展的血吸虫病流行病学专题调查数据分别计算居民不同年龄组、性别和流行村类型等的专属血吸虫病患病率。根据专题调查得出的年龄别伤残权重,按年龄和性别分层,求得健康寿命损失年（YLD）及YLD率,并推算两县的总体YLD。结果当涂县总体YLD为1056.26人年,汉寿县总体YLD为3967.43人年。两县一类村YLD占慢性血吸虫病疾病负担的37.95%,高年龄组和男性的YLD率较高。与非流行区比较,慢性血吸虫病给流行区人口平均增加了4.398人年/1000人（当涂县）和1.505人年/1000人（汉寿县）的疾病负担。结论对慢性血吸虫病YLD进行评价,有助于确定重点干预地区和人群,并可为干预措施的效果评价等提供新指标。     

Estimating the burden of scleroderma disease in Spain

OBJECTIVE: Scleroderma (systemic sclerosis) is a rare disease that results in great suffering. We estimated the burden of disease posed by scleroderma and its relative importance in the health of the Spanish population. METHODS: We estimated scleroderma-based burden of disease following procedures developed for the Global Burden of Disease study to ensure comparability. RESULTS: Despite its low prevalence, scleroderma generated 1732 disability-adjusted life-years (DALY) in Spain in 2001, comprising 562 (32%) years of life lost and 1170 (68%) years lived with disability. Most scleroderma-related DALY (73%) occurred in the population aged 15-54 years. Estimated DALY accounted for 0.59% of other musculoskeletal disorder-related DALY in the European A subregion (countries with low mortality rate in both adults and children in the World Health Organization classification), a significant value in the overall burden of disease. CONCLUSION: The burden of scleroderma in Spain was high, with disability being the major contributing factor. Burden of disease is an important measure in rare diseases, and may be an important indicator to be considered as a health unit in developed countries.     

华东某农村地区戊型肝炎负担的调查

目的分析戊型肝炎的疾病负担,为卫生决策提供科学依据。方法采用问卷调查方式,对江苏省东台市农村人群戊型肝炎主动监测网络收集的病例进行调查,获得戊型肝炎的疾病负担情况。结果戊型肝炎的总经济负担为2 910 362.60元,人均经济负担为11 641.45元,是东台市农村居民人均纯收入的1.26倍;失能调整生命年为28.94人年,患者的负担强度为115.78人年/千人。结论戊型肝炎的疾病负担较重,应加大防制力度。