1990—2019年中国妇科疾病的疾病负担变化趋势

目的 分析1990—2019年我国妇科疾病负担变化，分析不同年龄女性妇科疾病的主要类型，为妇科疾病的防治策略的制定提供科学依据。方法 采用2019年全球疾病负担研究数据结果，采用患病率描述妇科疾病的患病情况，采用伤残调整生命年（DALY）、早死损失生命年（YLL）和伤残损失生命年（YLD）评估妇科病总体和各亚病种的疾病负担，分析疾病负担的变化趋势、变化率及不同年龄妇科疾病的主要类型。结果 与1990年相比，2019年我国妇科疾病患病率（36.24%）、DALY率（626.54/10万）和YLD率（623.31/10万）总体呈现下降趋势，粗率变化率分别为 - 2.62%、 - 9.75%和 - 10.05%，妇科疾病YLL率（3.22/10万）总体呈现上升趋势，粗率变化率为163.83%。DALY率较大的妇科疾病为其他妇科疾病（如盆腔炎、阴道炎、宫颈炎等），YLL率占比高的妇科疾病有子宫肌瘤和生殖器脱垂。育龄妇女（15～49岁）经前期综合征和子宫内膜异位症的疾病负担较高，50～69岁妇女经前期综合征和子宫肌瘤的疾病负担较高，70岁以上妇女的生殖器脱垂和子宫肌瘤的疾病负担较高。1990—2019年我国妇科疾病负担整体低于全球水平，接近美国和日本水平。结论 我国妇科疾病的疾病负担总体呈现下降趋势，但是因妇科疾病导致的寿命损失仍不容忽视，可以依据不同年龄妇女疾病特征，开展有针对性的普查，提高诊疗技术，以降低我国妇科疾病负担。

Trend of disease burden of gynecological diseases in China from 1990 to 2019

To analyze the changes of gynecological disease burden in China from 1990 to 2019, and analyze themain types of gynecological diseases in women of different ages, so as to provide scientific evidence for prevention and treatment strategies of gynecological diseases. Methods The results of the Global Burden of Disease Study in 2019 were used todescribe the prevalence of gynecologic diseases. The disease burden of gynecological diseases was evaluated by disability adjusted life year (DALY), years of life lost (YLL) and years lived with disability (YLD). The change trend of disease burden andmain types of gynecological diseases in different ages was analyzed. Results Compared with 1990, the prevalence rate of gynecological diseases (36.24%), DALY rate (626.54/100 000) and YLD rate (623.31/100 000) showed a downward trend in2019, and the change rate of crude rate was -2.62%, -9.75%, and -10.05%, respectively. The YLL rate of gynecological diseases (3.22/100 000) showed an upward trend, and the change rate of crude rate was 163.83%. Other gynecological diseasessuch as pelvic inflammatory disease, vaginitis, and cervicitis had higher DALY rate, and the gynecological diseases withhigher proportion of YLL rate were uterine fibroids and genital prolapse. Women of childbearing age (15-49 years old) hadhigher disease burden of premenstrual syndrome and endometriosis, women of 50-69 years old had higher disease burden ofpremenstrual syndrome and hysteromyoma, and women over 70 years old had higher disease burden of genital prolapse andhysteromyoma. From 1990 to 2019, the overall burden of gynecological diseases in China was lower than the global level,close to the level of the United States and Japan. Conclusion The burden of gynecological diseases in China shows a downward trend, but the life loss caused by gynecological diseases cannot be ignored. According to the disease characteristics ofwomen of different ages, targeted census can be carried out. It is necessary to improve the diagnosis and treatment technology, so as to reduce the disease burden of gynecological diseases in China.