中国青年缺血性卒中的疾病负担变化趋势分析及预测

doi:10.3969/j.issn.1673-5765.2025.06.009

摘要/Abstract

摘要： 目的分析1990—2021年中国20～49岁青年缺血性卒中疾病负担的变化，并对2022—2035年青年缺血性卒中的发病情况进行预测。
方法基于2021年全球疾病负担数据库中关于中国青年缺血性卒中的数据，使用年龄标化发病率（age-standardized incidence rate，ASIR）、年龄标化死亡率（age-standardized mortality rate，ASMR）量化青年缺血性卒中的疾病流行情况，使用伤残调整寿命年（disability-adjusted life years，DALYs）及年龄标化伤残调整寿命年率（age-standardized DALYs rate，ASDR）量化疾病负担情况。分析中国青年缺血性卒中各危险因素相关DALYs的变化趋势。使用Segmented分段模型计算年度变化百分比并使用拟合回归模型计算年度变化百分比估计值（estimated annual percentage change，EAPC）来评估疾病趋势，同时预测2022—2035年青年缺血性卒中的发病率和发病人数。
结果中国青年缺血性卒中ASIR从1990年的18.28（95%UI 10.85～28.23）/10万上升至2021年的24.93（95%UI 16.09～36.88）/10万，EAPC为0.82%（95%CI 0.71%～0.92%）；ASMR从1990年的2.63（95%UI 2.13～3.25）/10万下降至2021年的1.88（95%UI 1.49～2.33）/10万，EAPC为-1.09%（95%CI -1.25%～-0.93%）；ASDR从1990年的182.87（95%UI 150.95～221.94）/10万下降至2021年的150.68（95%UI 122.19～180.70）/10万，EAPC为-0.64%（95%CI -0.74%～-0.54%）。预测模型显示，至2035年，中国青年缺血性卒中的ASIR将上升至25.40（95%CI 22.41～28.40）/10万，发病人数预计为132 303（95%CI 116 701～147 906）例。在危险因素中，代谢因素对青年缺血性卒中患者的DALYs影响最大，其次为行为因素。
结论 1990—2021年中国青年缺血性卒中的ASIR呈上升趋势，ASDR、ASMR呈下降趋势，预计2035年中国青年缺血性卒中的疾病负担仍较重，未来尤其应该重视代谢因素的防控。

文章导读： 本研究发现，1990—2021年中国青年缺血性卒中的发病率呈现上升趋势，至2035年仍可能继续上升。结果提示我国应加强对青年缺血性卒中的防控，制订适当的公共预防策略，降低其发病率，减轻疾病负担。

关键词: 缺血性卒中; 青年; 危险因素; 全球疾病负担数据库

Abstract: Objective To analyze the changes in the disease burden of ischemic stroke among Chinese young adults aged 20-49 years from 1990 to 2021, and to predict the incidence of ischemic stroke from 2022 to 2035.
Methods Based on the data from the global burden of disease 2021 database on ischemic stroke among Chinese young adults, the disease prevalence was quantified using age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR). The burden of the disease was quantified using disability-adjusted life years (DALYs) and age-standardized DALYs rate (ASDR). This paper analyzed the trends in DALYs associated with risk factors of ischemic stroke among Chinese young adults. The Segmented segmentation model was used to calculate the annual percentage change, and the fitted regression model was used to calculate the estimated annual percentage change (EAPC) to assess the disease trend, while also predicting the incidence rate and number of cases of ischemic stroke among young adults from 2022 to 2035.
Results The ASIR of ischemic stroke among Chinese young adults has increased from 18.28 (95%UI 10.85-28.23)/100 000 in 1990 to 24.93 (95%UI 16.09-36.88)/100 000 in 2021, with an EAPC of 0.82% (95%CI 0.71%-0.92%). The ASMR has decreased from 2.63 (95%UI 2.13-3.25)/100 000 in 1990 to 1.88 (95%UI 1.49-2.33)/100 000 in 2021, with an EAPC of -1.09% (95%CI -1.25% - -0.93%). The ASDR has decreased from 182.87 (95%UI 150.95-221.94)/100 000 in 1990 to 150.68 (95%UI 122.19-180.70)/100 000 in 2021, with an EAPC of -0.64% (95%CI -0.74%--0.54%). The prediction models indicate that by 2035, the ASIR of ischemic stroke among Chinese young adults will rise to 25.40 (95%CI 22.41-28.40)/100 000, affecting an estimated 132 303 (95%CI 116 701-147 906) cases. Among the risk factors, metabolic factors have the greatest impact on DALYs in the young stroke patients, followed by behavioral factors.
Conclusions From 1990 to 2021, the ASIR of ischemic stroke among Chinese young adults showed an upward trend, while the ASDR and ASMR showed a downward trend. By 2035, the disease burden of ischemic stroke among Chinese young adults will still be significant, emphasizing the importance of focusing on the prevention and control of metabolic factors in the future.

Key words: Ischemic stroke; Young adult; Risk factor; Global burden of disease

中图分类号:

王小军, 杨珂珂, 吴健恒, 林铎, 李晨威, 彭慧渊. 中国青年缺血性卒中的疾病负担变化趋势分析及预测[J]. 中国卒中杂志, 2025, 20(6): 734-745.

WANG Xiaojun, YANG Keke, WU Jianheng, LIN Duo, LI Chenwei, PENG Huiyuan. Analysis and Prediction of the Trend in Disease Burden of Ischemic Stroke among Chinese Young Adults[J]. Chinese Journal of Stroke, 2025, 20(6): 734-745.

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