Article(id=1241102744547807613, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202402111, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1708185600000, receivedDateStr=2024-02-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831552874, onlineDateStr=2026-03-18, pubDate=1721836800000, pubDateStr=2024-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831552874, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831552874, creator=13701087609, updateTime=1773831552874, updator=13701087609, issue=Issue{id=1241102730337505325, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831549486, creator=13701087609, updateTime=1773831697291, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103350322745680, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103350322745681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2683, endPage=2688, ext={EN=ArticleExt(id=1241102744904323500, articleId=1241102744547807613, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Disease burden of migraine in the Chinese population and forecast of future trends,1990-2019, columnId=1228016569138213037, journalTitle=Modern Preventive Medicine, columnName=Clinical Medicine and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To assess the disease burden of migraine in China from 1990 to 2019 and predict the changing trends in disease burden from 2020 to 2030, which may provide reliable data support for public health decision-making.

Methods

The study utilized data from the Global Burden of Disease 2019 (GBD2019) database and analyzed the age-standardized incidence rate (ASIR) and age-standardized DALY rate of migraine in China from 1990 to 2019. Estimation of annual percentage change (EAPC) models and Bayesian age-period-cohort (BAPC) analysis methods were employed to reveal changes and trends.

Results

From 1990 to 2019, both the ASIR and age-standardized DALY rate of migraine in China showed an upward trend, with EAPCs of 0.24% (95%CI: 0.20%-0.29%) and 0.27% (95%CI: 0.22%-0.32%), respectively. The highest ASIR for migraine was observed in the age group of 10-15 years, followed by a fluctuating decline, and then an increase in ASIR in the 25-30 age group. The age-standardized DALY rate peaked in the 40-45 age group. Disease burden indicators for females exceeded those for males during the same period. According to the BAPC model predictions, the ASIR for migraine in the entire population of China was expected to increase from 2020 to 2030, with an annual growth rate of 0.88%. The annual growth rates of ASIR for males and females were projected to be 1.21% and 0.64%, respectively.

Conclusion

The burden of migraine in China remains quite severe, and there should be a focus on adolescents and young to middle-aged populations. Customized prevention and intervention strategies are crucial for high-risk populations of different ages and genders.

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目的

了解中国1990—2019 年偏头痛的疾病负担情况,并预测2020—2030 年的疾病负担变化趋势,旨在为公共卫生决策提供可靠的数据支持。

方法

研究采用全球疾病负担2019(GBD2019)数据,对1990年至2019年中国偏头痛的年龄标准化发病率(ASIR)和年龄标化DALY率进行了分析。并使用估计年变化百分比(EAPC)模型和贝叶斯年龄-时期-队列分析(BAPC)方法揭示变化和趋势。

结果

从1990—2019 年,中国偏头痛的ASIR和年龄标化DALY率均呈上升趋势,其EAPC分别为0.24%(95%CI:0.20~0.29%)和0.27% (95%CI: 0.22~0.32%)。偏头痛的ASIR在10~15岁年龄段中达到最高,随后趋于波动式下降,在25~30岁ASIR呈现上升趋势。年龄标化DALY率在40~45岁组达到最高。女性的疾病负担指标均高于同时期的男性。根据BAPC模型预测结果,2020—2030 年中国偏头痛全人群ASIR呈现上升趋势,全人群ASIR年增长率为0.88%,男性和女性的ASIR年增长率分别为1.21%和0.64%。

结论

中国的偏头痛疾病负担仍然较为严重,应重点关注青少年和中青年人群,制定定制化的预防和干预策略至关重要。

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刘伦,E-mail:
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刘伦(1981—),女,硕士,主治医师,研究方向:病案信息

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Advances in the burden of migraine[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2022, 22(2): 69-72., articleTitle=Advances in the burden of migraine, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241102749337703119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, xref=null, ext=[AuthorCompanyExt(id=1241102749341897424, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, companyId=1241102749337703119, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Medical Record Statistics,First Hospital of Wuhan, Wuhan, Hubei 430030, China), AuthorCompanyExt(id=1241102749350286033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, companyId=1241102749337703119, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=武汉市第一医院 病案统计室,湖北 武汉 430030)])], figs=[ArticleFig(id=1241102753250988931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=EN, label=Fig.1, caption=Age Trends in ASIR of Migraine Among Different Genders in China, 2019, figureFileSmall=1PjsbdGZWlpDis3N3g5hCg==, figureFileBig=9uKtcdj7yiof0Mh0rM6CAw==, tableContent=null), ArticleFig(id=1241102753347457930, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=CN, label=图1, caption=2019年中国不同性别人群偏头痛ASIR年龄变化趋势, figureFileSmall=1PjsbdGZWlpDis3N3g5hCg==, figureFileBig=9uKtcdj7yiof0Mh0rM6CAw==, tableContent=null), ArticleFig(id=1241102753687196576, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=EN, label=Fig.2, caption=Trends in DALY for Migraine by Age and Gender in China, 2019, figureFileSmall=u3yAdMmSXe/wtzDtjNJRVQ==, figureFileBig=ZAVzZgMjwRyovEp4sRW9cg==, tableContent=null), ArticleFig(id=1241102753796248487, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=CN, label=图2, caption=2019年中国不同性别人群不同年龄偏头痛DALY变化趋势, figureFileSmall=u3yAdMmSXe/wtzDtjNJRVQ==, figureFileBig=ZAVzZgMjwRyovEp4sRW9cg==, tableContent=null), ArticleFig(id=1241102753875940268, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=EN, label=Fig.3, caption=Trends in Age-Standardized Incidence Rates (ASIR) of Migraine by Gender in China from 1990 to 2030, figureFileSmall=IrLgxUExjGUjaBGWHOtWPg==, figureFileBig=rrpLofq6nd5K4h0TNtEWKg==, tableContent=null), ArticleFig(id=1241102754014352309, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=CN, label=图3, caption=1990—2030年中国不同性别人群偏头痛ASIR变化趋势, figureFileSmall=IrLgxUExjGUjaBGWHOtWPg==, figureFileBig=rrpLofq6nd5K4h0TNtEWKg==, tableContent=null), ArticleFig(id=1241102754123404222, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=EN, label=Table 1, caption=

Trends in Migraine Incidence Among the Chinese Population from 1990 to 2019

, figureFileSmall=null, figureFileBig=null, tableContent=
人群199020191990—2019
EPAC (%, 95%CI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
全人群1 131.06
(985.06~1 274.59)
898.39
(783.14~1 004.15)
1 293.98
(1 146.34~1 448.51)
961.69
(845.91~1 079.18)
0.24
(0.20~0.29)
男性419.25
(362.31~478.48)
643.22
(562.07~729.16)
478.27
(420.06~537.11)
697.27
(608.73~787.11)
0.26
(0.22~0.31)
女性711.81
(619.81~796.49)
1 170.82
(1 029.71~1 304.11)
815.71
(723.82~919.19)
1 247.58
(1 100.46~1 400.14)
0.23
(0.19~0.28)
), ArticleFig(id=1241102754240844741, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=CN, label=表1, caption=

中国人群1990—2019年偏头痛发病率变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
人群199020191990—2019
EPAC (%, 95%CI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
全人群1 131.06
(985.06~1 274.59)
898.39
(783.14~1 004.15)
1 293.98
(1 146.34~1 448.51)
961.69
(845.91~1 079.18)
0.24
(0.20~0.29)
男性419.25
(362.31~478.48)
643.22
(562.07~729.16)
478.27
(420.06~537.11)
697.27
(608.73~787.11)
0.26
(0.22~0.31)
女性711.81
(619.81~796.49)
1 170.82
(1 029.71~1 304.11)
815.71
(723.82~919.19)
1 247.58
(1 100.46~1 400.14)
0.23
(0.19~0.28)
), ArticleFig(id=1241102754375062477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=EN, label=Table 2, caption=

Trends in Migraine Disease Burden by Gender in China from 1990 to 2019

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病负担199020191990—2019
EPAC (%, 95%CI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
全人群492.00
(77.68~1108.20)
404.81
(66.13~907.01)
708.94
(113.05~1609.72)
435.42
(63.68~991.80)
0.27
(0.22~0.32)
男性191.24
(39.8~421.27)
305.06
(67.1~665.76)
271.73
(58.05~602.31)
328.34
(64.15~740.77)
0.24
(0.20~0.29)
女性300.76
(37.94~697.54)
510.71
(67.15~1169.21)
437.21
(55.04~1026.75)
547.53
(63.88~1299.79)
0.27
(0.21~0.32)
), ArticleFig(id=1241102754475725778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102744547807613, language=CN, label=表2, caption=

中国不同性别人群1990—2019年偏头痛疾病负担变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病负担199020191990—2019
EPAC (%, 95%CI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
例数(×104)
(95%UI)
年龄标化率
(/10万,95% UI)
全人群492.00
(77.68~1108.20)
404.81
(66.13~907.01)
708.94
(113.05~1609.72)
435.42
(63.68~991.80)
0.27
(0.22~0.32)
男性191.24
(39.8~421.27)
305.06
(67.1~665.76)
271.73
(58.05~602.31)
328.34
(64.15~740.77)
0.24
(0.20~0.29)
女性300.76
(37.94~697.54)
510.71
(67.15~1169.21)
437.21
(55.04~1026.75)
547.53
(63.88~1299.79)
0.27
(0.21~0.32)
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1990—2019年中国人群偏头痛的疾病负担及未来变化趋势预测
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刘伦 , 曾云 , 寇沛 , 邝小娜
现代预防医学 | 临床与预防 2024,51(14): 2683-2688
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现代预防医学 | 临床与预防 2024, 51(14): 2683-2688
1990—2019年中国人群偏头痛的疾病负担及未来变化趋势预测
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刘伦 , 曾云, 寇沛, 邝小娜
作者信息
  • 武汉市第一医院 病案统计室,湖北 武汉 430030
  • 刘伦(1981—),女,硕士,主治医师,研究方向:病案信息

通讯作者:

刘伦,E-mail:
Disease burden of migraine in the Chinese population and forecast of future trends,1990-2019
Lun LIU , Yun ZENG, Pei KOU, Xiao-na KUANG
Affiliations
  • Department of Medical Record Statistics,First Hospital of Wuhan, Wuhan, Hubei 430030, China
出版时间: 2024-07-25 doi: 10.20043/j.cnki.MPM.202402111
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目的

了解中国1990—2019 年偏头痛的疾病负担情况,并预测2020—2030 年的疾病负担变化趋势,旨在为公共卫生决策提供可靠的数据支持。

方法

研究采用全球疾病负担2019(GBD2019)数据,对1990年至2019年中国偏头痛的年龄标准化发病率(ASIR)和年龄标化DALY率进行了分析。并使用估计年变化百分比(EAPC)模型和贝叶斯年龄-时期-队列分析(BAPC)方法揭示变化和趋势。

结果

从1990—2019 年,中国偏头痛的ASIR和年龄标化DALY率均呈上升趋势,其EAPC分别为0.24%(95%CI:0.20~0.29%)和0.27% (95%CI: 0.22~0.32%)。偏头痛的ASIR在10~15岁年龄段中达到最高,随后趋于波动式下降,在25~30岁ASIR呈现上升趋势。年龄标化DALY率在40~45岁组达到最高。女性的疾病负担指标均高于同时期的男性。根据BAPC模型预测结果,2020—2030 年中国偏头痛全人群ASIR呈现上升趋势,全人群ASIR年增长率为0.88%,男性和女性的ASIR年增长率分别为1.21%和0.64%。

结论

中国的偏头痛疾病负担仍然较为严重,应重点关注青少年和中青年人群,制定定制化的预防和干预策略至关重要。

偏头痛  /  疾病负担  /  伤残调整寿命年  /  贝叶斯-时期-队列分析
Objective

To assess the disease burden of migraine in China from 1990 to 2019 and predict the changing trends in disease burden from 2020 to 2030, which may provide reliable data support for public health decision-making.

Methods

The study utilized data from the Global Burden of Disease 2019 (GBD2019) database and analyzed the age-standardized incidence rate (ASIR) and age-standardized DALY rate of migraine in China from 1990 to 2019. Estimation of annual percentage change (EAPC) models and Bayesian age-period-cohort (BAPC) analysis methods were employed to reveal changes and trends.

Results

From 1990 to 2019, both the ASIR and age-standardized DALY rate of migraine in China showed an upward trend, with EAPCs of 0.24% (95%CI: 0.20%-0.29%) and 0.27% (95%CI: 0.22%-0.32%), respectively. The highest ASIR for migraine was observed in the age group of 10-15 years, followed by a fluctuating decline, and then an increase in ASIR in the 25-30 age group. The age-standardized DALY rate peaked in the 40-45 age group. Disease burden indicators for females exceeded those for males during the same period. According to the BAPC model predictions, the ASIR for migraine in the entire population of China was expected to increase from 2020 to 2030, with an annual growth rate of 0.88%. The annual growth rates of ASIR for males and females were projected to be 1.21% and 0.64%, respectively.

Conclusion

The burden of migraine in China remains quite severe, and there should be a focus on adolescents and young to middle-aged populations. Customized prevention and intervention strategies are crucial for high-risk populations of different ages and genders.

Migraine  /  Disease burden  /  Disability-Adjusted Life Years  /  Bayesian age-period-cohort analysis
刘伦, 曾云, 寇沛, 邝小娜. 1990—2019年中国人群偏头痛的疾病负担及未来变化趋势预测. 现代预防医学, 2024 , 51 (14) : 2683 -2688 . DOI: 10.20043/j.cnki.MPM.202402111
Lun LIU, Yun ZENG, Pei KOU, Xiao-na KUANG. Disease burden of migraine in the Chinese population and forecast of future trends,1990-2019[J]. Modern Preventive Medicine, 2024 , 51 (14) : 2683 -2688 . DOI: 10.20043/j.cnki.MPM.202402111
偏头痛是一种常见且反复发作的慢性神经系统疾病,主要引起中、重度头痛,常伴有恶心、呕吐、畏光和恐音,严重影响了患者生活质量[1]。根据全球疾病负担(The Global Burden of Disease Study,GBD)2019结果显示,全球偏头痛患病人数约为11.28亿,引起的伤残调整生命年(Disability-adjusted life years,DALY)达4 208万,与1990年相比,增长了56.64%,居全球病因第14位[2]。在所有疾病中,偏头痛导致的健康寿命损失位居第二,特别是在15至49岁的女性群体中,其影响居于首位[3]。偏头痛已成为一个不容忽视的公共卫生问题,不仅给患者带来极大痛苦,还对社会和经济造成巨大负担[4-5]。随着经济的快速发展和人口结构的变化,中国的偏头痛的疾病负担日益凸显。最新的研究主要关注中国育龄妇女偏头痛发病率的时间变化趋势[6],迫切需要全人群的深入探索和分析。本研究基于GBD 2019的数据,旨在全面分析1990至2019年间中国偏头痛的疾病负担,并对2020—2030年疾病负担变化趋势进行预测。通过本研究,有助于医疗卫生工作者更深入地认识偏头痛,为政策制定者提供了科学依据,以改善资源分配和制定有效的健康策略。
本研究采用了GBD 2019数据库中的数据(http://ghdx.healthdata.org/gbd-results-tool/)。该数据库提供了自1990年至2019年全球368种疾病和伤害的数据,覆盖了204个国家和地区。在GBD 2019数据库中,中国的偏头痛相关数据主要来源于国家级和地区级的疾病监测系统、统计局数据、以及期刊文献。这些来源确保了数据的多样性和覆盖性,GBD采用统一的方法论整合和标准化这些数据,确保其地区代表性和可靠性(https://www.healthdata.org/sites/default/files/files/Projects/GBD/Data%20sources%20used%20in%20GBD_final.pdf)。本次研究偏头痛数据ICD10编码为G43-G43.919,为无法治愈的、未特指类型,且不伴有偏头痛持续状态的偏头痛[7]。GBD2019数据库筛选具体方法如下:病因“Migraine”;性别包括“both”、“female”和“male”,年龄选取以5岁为一组,从0岁一直到95岁及以上。人口预测数据来自联合国经济和社会事务部发布的《世界人口展望2022》(https://population.un.org/wpp/Download/Standard/CSV/)和《世界标准人口分布》(https://seer.cancer.gov/stdpopulations/world.who.html)中的人口预测数据。
由于偏头痛不涉及直接死亡,我们选取了发病率和DALY来衡量其对人群健康的影响。DALY是指某个疾病从发病到终结整个过程中生命年的总损失。为了确保数据的可比性,采用《世界标准人口》进行年龄标准化发病率(age-standardized incidence rates, ASIR)的调整。DALY和ASIR的95%不确定区间(Uncertainty interval, UI)是通过贝叶斯偏回归模型DisMod-MR 2.1来估算[8]
评估1990—2019年间偏头痛疾病负担的时间变化趋势,我们使用了估计年变化百分比(estimated annual percentage changes, EAPC)模型[9]。该模型采用线性回归分析,用于定量评估偏头痛ASIR随时间的变化。EAPC及其95%置信区间(confidence interval, CI)的计算有助于判断ASIR的趋势是上升还是下降。当EAPC的95%CI的下限大于0,则表示ASIR呈上升趋势;当EAPC的95%CI的下限小于0,则ASIR呈下降趋势。
本研究应用贝叶斯年龄-时期-队列分析(Bayesian age-period-cohort analysis, BAPC)方法,该方法考虑了年龄、时期和队列因素的影响,常用于疾病的发病和死亡趋势预测[6]。采用对数线性泊松模型,并假设年龄、时期和队列因素之间存在乘法效应。此外,为了调整过离散现象,该模型采用了二阶随机行走模型,见公式(1):
公式(1)中,i(1≤iI)表示时间节点,i(1≤iJ)表示年龄组,α表示截距,μi表示年龄效应;βj表示时期效应;γk表示队列效应。
数据分析采用R 4.3.1软件,使用“R-BAPC”包和“R-INLA”包来实现对2030年中国偏头痛发病ASIR的预测,检验水准α=0.05。
中国偏头痛2019年ASIR为961.69/10万(95% UI:845.91~1079.18/10万),与1990年相比,ASIR上升了0.24%。女性的ASIR比男性高,为1247.58 /10万,约为男性的1.8倍。自1990到2019年,无论男性、女性还是全人群的偏头痛ASIR均呈上升趋势,EAPC分别为0.26%、0.23%和0.24%,见表1
中国偏头痛随着年龄的增加ASIR逐渐升高,在10~15岁年龄段中达到最高,且男性ASIR均低于女性,随后趋于波动式下降,在25~30岁ASIR呈现上升趋势。见图1
2019年中国全人群偏头痛年龄标化DALY率为435.42/10万,与1990年相比,年龄标化DALY率上升了0.27% (95% CI: 0.22~0.32%),见表2。随着年龄的增加,偏头痛年龄标化DALY率逐渐增加,在40~45岁组标化DALY率达到最高,然后开始呈现下降趋势。女性各年龄的标化DALY率均高于男性,详见图2
2020至 2030 年间,中国人群偏头痛的发病率继续呈现上升趋势,见图3。其中,全人群发病率从 2020 年的914.38/10万(904.15/10万~924.71/10万)上升至2030年的937.59/10万(927.97/10万~947.67/10万)上,年增长率为0.23%(95%CI:0.217%~0.244%);ASIR从2020年的974.45/10万(973.91/10万~975.04/10万)上升至2030年的1 063.61/10万(1 063.23/10万~1 064.46/10万),年增长率为0.80%(95%CI:0.80%~0.80%);男性偏头痛发病的发病率从 2020年的665.51/10万(652.29/10万~678.93/10万)上升至2030年的716.42/10万(704.33/10万~729.15/10万),年增长率为0.67%(95%CI:0.63%~0.73%);男性偏头痛ASIR从 2020 年的708.81/10万(708.18/10万~709.51/10万)上升至2030年的804.02/10万(803.28/10万~804.76/10万),年增长率为1.15%(95%CI:1.15%~1.15%);女性偏头痛发病的发病率则出现下降趋势,从 2020年的1 173.07/10万(1 157.45/10万~1 188.81/10万)下降至2030年的1 165.07/10万(1 149.79/10万~1 180.6/10万),年下降率为0.06%(95%CI:0.06%~0.06%);但女性偏头痛ASIR从2020年的1 261.6/10万(1 260.68/10万~1 262.54/10万)上升至2030年的1 350.57/10万(1 349.71/10万~1 351.74/10万),年增长率为0.62%(95%CI:0.62%~0.62%)。
偏头痛作为中国人群中日益严重的公共卫生问题,本研究从1990年到2019年对其疾病负担进行了深入分析。我们发现,在这30年间,偏头痛的ASIR呈现上升趋势,尤其在青少年(10~15岁)和青年人群(25~30岁)中较为显著。女性在各年龄阶段的发病率普遍高于男性。同时,我们注意到偏头痛的年龄标准化DALY率也呈现上升趋势,其中40~45岁年龄组最为显著。根据BAPC模型的预测,2020至2030年间,中国人群的偏头痛ASIR可能会继续增长,尽管男性的发病率低于女性,但其年增长率是女性的两倍。
研究结果表明,中国偏头痛发病率逐渐上升,这一趋势与基于其他数据的分析结果一致[10],并且与全球范围内的偏头痛趋势相符[11],从而进一步证实了中国偏头痛发病率的呈增长趋势。偏头痛的发生与不健康的生活方式、环境因素以及心理因素密切有关。随着中国经济的快速发展,社会竞争日益激烈,工作压力不断增加,长时间的精神紧张和压力成为导致偏头痛增加的主要因素;同时,由于压力诱发的睡眠质量下降在偏头痛的发病中也扮演着重要角色[12-13]。随着生活节奏的加快,食用高糖、高脂肪和富含咖啡因的食物逐渐增多,这一现象在偏头痛患者中尤为明显[14-15]。研究还显示,环境空气污染和气候变化会与偏头痛发病率增加相关[16-17]。此外,缺乏体育锻炼的人以及患有焦虑/压力的人更容易罹患偏头痛[18-19]
研究表明,女性的偏头痛发病率普遍高于男性。这一差异可能是多种生理、遗传和社会心理因素相互作用的结果。女性的激素水平,尤其是雌激素,对偏头痛有显著影响,其水平变化被认为是触发偏头痛的因素之一[20]。此外,女性可能面临的独特社会和心理压力,例如来自家庭和职业生活的双重压力,这可能增加了她们罹患偏头痛的风险。研究还发现,青少年和青壮年偏头痛的疾病负担日益加重。10~15岁这一年龄段的孩子面临学校成绩的压力,青春期的生理变化,以及身心快速变化导致压力增加,从而增加偏头痛发作的风险[21-22]。同时,过度使用电子设备、睡眠不足和不良饮食习惯也可能是偏头痛的触发因素[23]。同时,青年人群(25~30岁)往往承担更多的工作责任,她们面临工作压力、结婚、育儿等生活事件、同时常常不规律的作息和不健康的生活习惯,这些因素均可能导致偏头痛的发生[12,18]
2019年,中国全人群偏头痛年龄标化DALY率为435.42/10万,相较于1990年上升了0.27%。这一上升趋势显示,偏头痛对中国人群的整体健康影响正在增加,特别是在40~45岁年龄组,DALY率达到最高点,这可能与生活压力、健康状况以及慢性疾病的累积有关[24]。此外,女性在各个年龄组的年龄标化DALY率普遍高于男性,这与女性偏头痛发病率高于男性一致。同时,随着年龄的增加,尤其是高龄女性的年龄标化DALY率与男性差异逐渐缩小。这种现象可能是因为随着年龄的增长,一些与年轻时期有关的生理差异,如生育相关因素和激素水平的变化,在老年人群中不再如此显著,从而减少了性别差异。需要指出的还是,这些机制的确切作用仍要更多的研究来加以验证。
根据BAPC模型预测显示,从2020至2030年间,中国人群偏头痛的ASIR预计将继续上升。这种增长趋势在男性和女性中均存在,但男性的年增长率(1.15%)高于女性(0.62%)。这一预测揭示了未来十年内偏头痛在中国人群中可能会成为更加突出的公共健康问题,男性偏头痛问题应重点给予关注。但值得注意的事,女性非标化的偏头痛发病率呈现下降趋势,但ASIR是对年龄结构进行调整后的发病率,用以反映如果人口结构保持不变时的疾病发生情况。我国正在经历人口老龄化,这种人口结构的变化可能导致虽然总体人数中偏头痛患者数量减少,但标准化人口后,发病率出现增加的趋势。偏头痛不仅对个人的生活质量、工作能力以及家庭关系造成重大影响,还导致巨大的疾病负担和经济负担[25]。因此,政府应采取一系列措施来应对偏头痛的问题,包括加强公众对偏头痛的认识和教育,提高人们对该疾病的了解,以便更早地诊断和治疗。此外,政府还应鼓励和推广健康的生活方式,包括规律的睡眠模式、均衡饮食和适量的运动,这些都可以有助于降低偏头痛的发病率。针对性地制定预防和干预措施,尤其是针对男性和年轻人群,可以帮助减轻偏头痛带来的负担,改善他们的生活质量。
综上所述,中国的偏头痛疾病负担仍然较为严重,尤其需要应重点关注青少年和中青年人群。政府和公共卫生部门应综合采取预防和干预措施,有效地减轻偏头痛对中国人群健康和生活质量的影响,提高整体的公共健康水平。
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2024年第51卷第14期
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doi: 10.20043/j.cnki.MPM.202402111
  • 接收时间:2024-02-18
  • 首发时间:2026-03-18
  • 出版时间:2024-07-25
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  • 收稿日期:2024-02-18
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    武汉市第一医院 病案统计室,湖北 武汉 430030

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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