大型前瞻性人群队列研究进展

  目的  了解中国队列研究的建立和发展现状，为今后中国队列研究的建设提供参考依据。  方法  检索PubMed数据库、中国知识资源数据库（CNKI）和中国生物医学文献数据库（CBM），收集数据库收录起始日期至2019年3月10日已发表文献的队列研究，并在“国家科技管理信息系统公共服务平台”、“国家卫生健康委医药卫生科技发展研究中心”和“中国生物技术发展中心”网站中检索2016年1月1日 — 2019年5月1日新立项的队列研究项目，分析中国队列的建立和发展现状。  结果  共纳入已有文献发表的中国队列研究470个，其中前瞻性队列研究360个（76.60 %），回顾性队列研究103个（21.91 %），双向性队列研究7个（1.49 %）；自然人群队列研究177个（37.66 %），专病队列研究154个（32.77 %），母婴队列研究88个（18.72 %），职业队列研究45个（9.57 %），死亡队列研究6个（1.28 %）。共纳入新立项未发表文献的队列研究项目26项，其中精准医学研究23项（88.46 %），生殖健康及重大出生缺陷防控研究1项（3.85 %），重大慢性非传染性疾病防控研究2项（7.69 %）；自然人群队列研究8项（30.77 %），专病队列研究18项（69.23 %）。国内自1974年开始建立队列研究，为前瞻性职业队列研究，四川、北京、江苏、上海、广东、香港地区建立队列研究数量最多；随着样本量的增加，队列研究数量逐渐减少。有345个（73.40 %）队列研究目前已经停止发表文献，正在进行的队列研究125个（26.60 %）；已停止发表文献的队列研究中，随访时间 > 20年的队列研究仅25个（7.25 %）。2016 — 2018年国家重点研发计划中立项的26项队列研究项目的牵头承担单位涉及10个地区，其中立项最多的为北京[14项（53.8 %）]，其次为上海[3项（11.5 %）]和陕西[2项（7.6 %）]；立项总金额为392 790 000元，其中北京所占比例最高（32.10 %），其次为江苏（16.55 %）。  结论  中国队列研究建立起步较晚、规模较小、持续时间较短，分布相对集中，且长期随访的队列研究较少。

Introduction to epidemiological studies

  Objective  To examine historical development and present status of cohort studies in China and to provide references for the establishment of domestic research cohorts.  Method  Through PubMed, China National Knowledge Infrastructure (CNKI), Chinese Biology Medicine (CBM) database, we retrieved cohort studies in China published till March 10th, 2019; we also collected information on cohort studies newly established in China between January 1st, 2016 and May 1st 2019 via the websites of Public Service Platform of National Science and Technology Information System, Development Center for Medical Science and Technology of National Health Commission of the People′s Republic of China, and China National Center for Biotechnology Development. Historical development and present status of cohort studies in China were analyzed based on the data collected.  Results  Totally 470 published cohort studies in China were enrolled in the study, including 360 (76.60%) prospective, 103 (21.91%) historical and 7 (1.49%) ambispective studies; of all the studies, 177 (37.66%) were conducted in general populations and 88 (18.72%) in maternal and child groups; 154 (32.77%), 45 (9.57%), and 6 (1.28%) were for specific diseases, occupational diseases, and mortality, respectively. A total of 26 newly established cohorts were identified, of which 23 (88.46%) were on precision medicine initiative, 1 (3.85%) on prevention and control of reproductive health and major birth defects, and 2 (7.69%) on major non-communicable chronic diseases; of all the new cohorts, 8 (30.77%) were established in general populations and 18 (69.23%) in populations susceptible to specific diseases. The first cohort in China was established among a occupational population for prospective study cohort in 1974. More cohort studies were conducted in Beijing and Shanghai municipality, Jiangsu and Guangdong province, and Hong Kong Special Administrative Region and more cohort studies involved a relatively small number of participants. For all the published cohort studies, 345 (73.40%) had no new results to be published in the last three years, of which, 25 (7.25%) followed up the participants more than 20 years; while 125 (26.60%) were still going on. During 2016 – 2018, a total of 26 cohort studies were approved by National Key Research and Development Plan and these studies were sponsored by institutions in 10 provincial regions; of the approved cohort studies, 14 (53.8%), 3 (11.5%), and 2 (7.6%) were sponsored by the institutions in Beijing, Shanghai, and Shanxi province, respectively. The total funding to the approved cohort studies was 392 790 000 RMB yuan and 32.10% and 16.55% of the funding were for the studies sponsored by the institutions in Beijing and Jiangsu province.  Conclusion  Cohort studies in China were conducted relatively late and the studies were generally with smaller sample size, shorter follow-up duration and being carried out in limited regions.