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Article(id=1324078091492008112, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202504185, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744214400000, receivedDateStr=2025-04-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614417193, onlineDateStr=2026-11-02, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614417193, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614417193, creator=13701087609, updateTime=1793614417193, updator=13701087609, issue=Issue{id=1324077868950631142, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614364134, creator='13701087609', updateTime=1793614446224, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078213328142371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078213332336676, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=747, endPage=752, ext={EN=ArticleExt(id=1324078091752054961, articleId=1324078091492008112, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Disease burden and prediction of alcoholic liver cirrhosis in China and Worldwide, 1990-2021, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the disease burden of alcoholic liver cirrhosis in China and globally from 1990 to 2021, and to predict the trend of burden changes from 2022 to 2050, providing a reference for the prevention and control of alcoholic liver cirrhosis in China.

Methods

Data on the prevalence, mortality, and disability adjusted life years (DALYs) rates of alcoholic liver cirrhosis in different gender and age groups in China and globally from 1990 to 2021, along with their 95% uncertainty intervals (95%UI), were obtained from the Global Burden of Disease (GBD) 2021 database. Joinpoint 5.0.1 software was used to calculate the temporal trends of the disease burden of alcoholic liver cirrhosis in China and globally. The nested Bayesian meta-regression model was employed to predict the burden of alcoholic liver cirrhosis.

Results

The age-standardized prevalence (average annual percent change [AAPC]=-0.93% and -0.46% respectively), age-standardized mortality (AAPC=-2.17% and -0.89% respectively), and age-standardized DALYs rate (AAPC=-2.26% and -0.86% respectively) of alcoholic liver cirrhosis in China and globally showed a downward trend from 1990 to 2021. The burden of alcoholic liver cirrhosis in males was more severe than that in females in both China and globally, and the burden in people aged 50 years and above was more severe than that in those aged 15-49 years. It is predicted that by 2050, the age-standardized mortality rate in China will be 0.68 per 100 000, and the age-standardized DALYs rate will be 20.60 per 100 000; globally, the age-standardized mortality rate will be 4.36 per 100 000, and the age-standardized DALYs rate will be 134.70 per 100 000.

Conclusion

The disease burden of alcoholic liver cirrhosis in China is lower than the global level, with significant gender and age differences. It is recommended to strengthen attention to high-risk groups, allocate more resources to prevention and early detection, promote health education, and encourage residents to adopt healthy lifestyles.

, authors=Cheng SHI1, Xu-peng CHEN1, Li-li GOU1, Ling-ling JIANG2, Hao-yu GUAN2, authorsList=Cheng SHI, Xu-peng CHEN, Li-li GOU, Ling-ling JIANG, Hao-yu GUAN, authorCompany=null, correspAuthors=Hao-yu GUAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078092725133496, articleId=1324078091492008112, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=1990—2021年中国与全球酒精性肝硬化疾病负担及预测研究, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析1990至2021年中国与全球酒精性肝硬化疾病负担情况，并预测2022至2050年的疾病负担变化趋势，为我国酒精性肝硬化防控工作提供参考依据。

方法

从2021全球疾病负担（GBD 2021）数据库获取1990—2021年全球和中国酒精性肝硬化在不同性别和年龄分组的患病率、死亡率和DALYs率及其95%不确定区间（95%UI），使用Joinpoint 5.0.1软件计算中国和全球酒精性肝硬化疾病负担的时间趋势，采用嵌套贝叶斯元回归模型预测酒精性肝硬化疾病负担。

结果

中国和全球酒精性肝硬化的标化患病率（AAPC分别为-0.93%和-0.46%）、标化死亡率（AAPC分别为-2.17%和-0.89%）和标化DALY率（AAPC分别为-2.26%和-0.86%）在1990-2021年间均呈下降趋势。中国和全球的男性酒精性肝硬化负担严重程度均高于女性，50岁及以上人群的肝硬化负担严重程度高于15~49岁人群。预测到2050年，中国酒精性肝硬化的标化死亡率为0.68/10万，标化DALY率为20.60/10万；全球酒精性肝硬化的标化死亡率为4.36/10万，标化DALY率为134.70/10万。

结论

我国酒精性肝硬化疾病负担低于全球水平，具有明显的性别差异和年龄差异，建议加强对高危人群的关注，将更多资源用于预防与早期发现，推进健康教育，促进居民形成健康的生活方式。

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石呈（1987—），男，硕士，副主任医师，研究方向：健康教育与健康促进

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官昊宇，E-mail:
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注：A为标化患病率，B为标化死亡率，C为标化DALY率。

, figureFileSmall=i4sLo1rRTfqcJEumFGi75w==, figureFileBig=pcREypYi1GXKqQ+iMedkVg==, tableContent=null), ArticleFig(id=1324078097112375519, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=EN, label=Fig.2, caption=Trends in disease burden of alcoholic liver cirrhosis by age group in China and globally from 1990 to 2021, figureFileSmall=zHUl3LTbYHc4FEK/2vG9Bg==, figureFileBig=tZsASk+FEBYws+4ndqkqxQ==, tableContent=null), ArticleFig(id=1324078097225621728, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=CN, label=图2, caption=1990—2021年中国和全球酒精性肝硬化不同年龄段疾病负担变化趋势

注：A为患病率，B为死亡率，C为DALY率。

, figureFileSmall=zHUl3LTbYHc4FEK/2vG9Bg==, figureFileBig=tZsASk+FEBYws+4ndqkqxQ==, tableContent=null), ArticleFig(id=1324078097305313505, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=EN, label=Fig.3, caption=Trends in standardized mortality and DALY rates of alcoholic liver cirrhosis in China and globally from 1990 to 2050, figureFileSmall=qpkxDOSDK68vJ67dyYiqzQ==, figureFileBig=SEaKCO0t60ygoyQLuejhZA==, tableContent=null), ArticleFig(id=1324078097380810978, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=CN, label=图3, caption=1990—2050年中国和全球酒精性肝硬化标化死亡率及标化DALY率变化趋势

注：A为标化死亡率，B为标化DALY率，阴影部分为95%UI。

, figureFileSmall=qpkxDOSDK68vJ67dyYiqzQ==, figureFileBig=SEaKCO0t60ygoyQLuejhZA==, tableContent=null), ArticleFig(id=1324078097447919843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=EN, label=Table 1, caption=

Burden of alcoholic liver cirrhosis in China and globally from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
标化患病率标化死亡率
中国全球中国全球
总人群
1990年（95%UI）（/10万）12.02（9.38~15.20）40.23（33.50~46.63）1.23（0.96~1.53）5.40（4.52~6.39）
2021年（95%UI）（/10万）9.06（7.23~11.16）34.81（28.88~40.26）0.63（0.47~0.84）4.08（3.45~4.81）
AAPC（95%CI）(%)-0.93（-0.97~-0.89）-0.46（-0.50~-0.43）-2.17（-2.34~-1.97）-0.89（-1.01~-0.77）
t值-44.31-26.23-20.82-15.16
P值<0.001<0.001<0.001<0.001
男性
1990年（95%UI）（/10万）19.46（15.19~24.70）57.56（48.61~66.60）2.05（1.53~2.61）8.72（7.38~10.30）
2021年（95%UI）（/10万）15.43（12.39~18.91）51.53（43.47~59.11）1.14 (0.84~1.54)6.66（5.70~7.82）
AAPC（95%CI）(%)-0.77（-0.81~-0.73）-0.36（-0.38~-0.33）-1.89（-2.11~-1.68）-0.86（-0.96~-0.76）
t值-38.39-25.45-16.78-17.00
P值<0.001<0.001<0.001<0.001
女性
1990年（95%UI）（/10万）4.32（3.30~5.52）23.81（19.22~28.43）0.43 (0.32~0.56)2.41（1.96~2.97）
2021年（95%UI）（/10万）2.69（2.12~3.37）18.73（15.01~22.27）0.15 (0.11~0.20)1.70（1.36~2.09）
AAPC（95%CI）(%)-1.54（-1.62~-1.46）-0.76（-0.82~-0.70）-3.44（-3.85~-3.03）-1.11（-1.27~-0.96）
t值-38.35-24.40-16.11-13.60
P值<0.001<0.001<0.001<0.001
标化DALY率
中国全球
总人群
1990年（95%UI）（/10万）37.60 (28.52~47.10)167.64（139.99~197.38）
2021年（95%UI）（/10万）18.61 (13.87~25.18)128.39（108.57~152.78）
AAPC（95%CI）(%)-2.26（-2.44~-2.08）-0.86（-1.00~-0.72）
t值-23.96-11.96
P值<0.001<0.001
男性
1990年（95%UI）（/10万）62.98 (46.83~80.49)270.69（229.01~318.87）
2021年（95%UI）（/10万）33.81 (24.47~46.30)210.86（179.45~249.08）
AAPC（95%CI）(%)-2.01（-2.19~-1.83）-0.79（-0.91~-0.67）
t值-21.55-12.74
P值<0.001<0.001
女性
1990年（95%UI）（/10万）11.19（8.24~14.64）68.85（55.56~83.74）
2021年（95%UI）（/10万）3.60（2.58~4.91）48.98（39.29~60.51）
AAPC（95%CI）(%)-3.65（-3.93~-3.37）-1.09（-1.27~-0.91）
t值-25.09-11.76
P值<0.001<0.001
), ArticleFig(id=1324078097544388836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=CN, label=表1, caption=

1990—2021年中国和全球酒精性肝硬化疾病负担情况

, figureFileSmall=null, figureFileBig=null, tableContent=
标化患病率标化死亡率
中国全球中国全球
总人群
1990年（95%UI）（/10万）12.02（9.38~15.20）40.23（33.50~46.63）1.23（0.96~1.53）5.40（4.52~6.39）
2021年（95%UI）（/10万）9.06（7.23~11.16）34.81（28.88~40.26）0.63（0.47~0.84）4.08（3.45~4.81）
AAPC（95%CI）(%)-0.93（-0.97~-0.89）-0.46（-0.50~-0.43）-2.17（-2.34~-1.97）-0.89（-1.01~-0.77）
t值-44.31-26.23-20.82-15.16
P值<0.001<0.001<0.001<0.001
男性
1990年（95%UI）（/10万）19.46（15.19~24.70）57.56（48.61~66.60）2.05（1.53~2.61）8.72（7.38~10.30）
2021年（95%UI）（/10万）15.43（12.39~18.91）51.53（43.47~59.11）1.14 (0.84~1.54)6.66（5.70~7.82）
AAPC（95%CI）(%)-0.77（-0.81~-0.73）-0.36（-0.38~-0.33）-1.89（-2.11~-1.68）-0.86（-0.96~-0.76）
t值-38.39-25.45-16.78-17.00
P值<0.001<0.001<0.001<0.001
女性
1990年（95%UI）（/10万）4.32（3.30~5.52）23.81（19.22~28.43）0.43 (0.32~0.56)2.41（1.96~2.97）
2021年（95%UI）（/10万）2.69（2.12~3.37）18.73（15.01~22.27）0.15 (0.11~0.20)1.70（1.36~2.09）
AAPC（95%CI）(%)-1.54（-1.62~-1.46）-0.76（-0.82~-0.70）-3.44（-3.85~-3.03）-1.11（-1.27~-0.96）
t值-38.35-24.40-16.11-13.60
P值<0.001<0.001<0.001<0.001
标化DALY率
中国全球
总人群
1990年（95%UI）（/10万）37.60 (28.52~47.10)167.64（139.99~197.38）
2021年（95%UI）（/10万）18.61 (13.87~25.18)128.39（108.57~152.78）
AAPC（95%CI）(%)-2.26（-2.44~-2.08）-0.86（-1.00~-0.72）
t值-23.96-11.96
P值<0.001<0.001
男性
1990年（95%UI）（/10万）62.98 (46.83~80.49)270.69（229.01~318.87）
2021年（95%UI）（/10万）33.81 (24.47~46.30)210.86（179.45~249.08）
AAPC（95%CI）(%)-2.01（-2.19~-1.83）-0.79（-0.91~-0.67）
t值-21.55-12.74
P值<0.001<0.001
女性
1990年（95%UI）（/10万）11.19（8.24~14.64）68.85（55.56~83.74）
2021年（95%UI）（/10万）3.60（2.58~4.91）48.98（39.29~60.51）
AAPC（95%CI）(%)-3.65（-3.93~-3.37）-1.09（-1.27~-0.91）
t值-25.09-11.76
P值<0.001<0.001
), ArticleFig(id=1324078097632469221, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=EN, label=Table 2, caption=

Burden of alcoholic liver cirrhosis in different age groups in China and globally from 1990 to 2021

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患病率死亡率
中国全球中国全球
15~49岁
1990年（95%UI）（/10万）6.04 (4.18~8.38)22.87 (17.57~28.78)0.38 (0.27~0.53)2.02 (1.62~2.47)
2021年（95%UI）（/10万）6.97 (5.12~9.43)25.79 (19.87~32.67)0.31 (0.22~ 0.44)2.05 (1.65~2.53)
AAPC（95%CI）(%)-0.48（0.26~0.70）0.40（0.35~0.48）-0.73（-1.14~-0.32）0.05（-0.18~0.28）
t值4.3317.33-3.450.46
P值<0.001<0.0010.0010.644
50~69岁
1990年（95%UI）（/10万）40.2 (27.94~55.08)125.95 (95.72~ 155.39)4.13 (3~5.39)17.7 (13.85~21.7)
2021年（95%UI）（/10万）30.5 (21.96~39.87)103.31 (78~128.14)1.99 (1.38~2.74)12.87 (10.3~15.72)
AAPC（95%CI）(%)-0.92（-0.99~-0.84）-0.63（-0.68~-0.58）-2.32（-2.52~-2.13）-1.00（-1.15~-0.86）
t值-25.3-26.41-22.93-13.47
P值<0.001<0.001<0.001<0.001
≥70岁
1990年（95%UI）（/10万）37.11 (23.97~53.7)127.52 (92.87~166.71)5.41 (3.9~7.22)23.47 (17.92~29.62)
2021年（95%UI）（/10万）25.74 (17.17~36.07)103.86 (75.84~134.66)3.19 (2.24~4.22)17.91 (13.63~21.71)
AAPC（95%CI）(%)-1.18（-1.24~-1.12）-0.66（-0.69~-0.62）-1.70（-2.10~-1.30）-0.87（-0.98~-0.75）
t值-39.70-39.02-8.19-14.93
P值<0.001<0.001<0.001<0.001
DALY率
中国全球
15~49岁
1990年（95%UI）（/10万）18.48 (13.35~25.09)99.09 (79.41~ 120.78)
2021年（95%UI）（/10万）14.43 (10.22~20.46)99.64 (80.88~ 122.53)
AAPC（95%CI）(%)-0.82（-1.05~-0.56）0.02（-0.19~0.23）
t值-6.970.17
P值<0.0010.862
50~69岁
1990年（95%UI）（/10万）131.99 (94.6~172.23)555.88 (433.9~ 681.29)
2021年（95%UI）（/10万）62.95 (43.72~87.66)402.98 (322.48~ 490.94)
AAPC（95%CI）(%)-2.35（-2.52~-2.19）-1.02（-1.16~-0.88）
t值-27.81-13.94
P值<0.001<0.001
≥70岁
1990年（95%UI）（/10万）93.36 (66.22~126.84)385.14 (293.18~ 483.32)
2021年（95%UI）（/10万）51.95 (35.51~70.16)287.94 (216.42~ 350.72)
AAPC（95%CI）(%)-1.89（-2.29~-1.48）-0.95（-1.00~-0.90）
t值-9.04-34.62
P值<0.001<0.001
), ArticleFig(id=1324078097724743910, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078091492008112, language=CN, label=表2, caption=

1990—2021年中国和全球不同年龄段酒精性肝硬化疾病负担情况

, figureFileSmall=null, figureFileBig=null, tableContent=
患病率死亡率
中国全球中国全球
15~49岁
1990年（95%UI）（/10万）6.04 (4.18~8.38)22.87 (17.57~28.78)0.38 (0.27~0.53)2.02 (1.62~2.47)
2021年（95%UI）（/10万）6.97 (5.12~9.43)25.79 (19.87~32.67)0.31 (0.22~ 0.44)2.05 (1.65~2.53)
AAPC（95%CI）(%)-0.48（0.26~0.70）0.40（0.35~0.48）-0.73（-1.14~-0.32）0.05（-0.18~0.28）
t值4.3317.33-3.450.46
P值<0.001<0.0010.0010.644
50~69岁
1990年（95%UI）（/10万）40.2 (27.94~55.08)125.95 (95.72~ 155.39)4.13 (3~5.39)17.7 (13.85~21.7)
2021年（95%UI）（/10万）30.5 (21.96~39.87)103.31 (78~128.14)1.99 (1.38~2.74)12.87 (10.3~15.72)
AAPC（95%CI）(%)-0.92（-0.99~-0.84）-0.63（-0.68~-0.58）-2.32（-2.52~-2.13）-1.00（-1.15~-0.86）
t值-25.3-26.41-22.93-13.47
P值<0.001<0.001<0.001<0.001
≥70岁
1990年（95%UI）（/10万）37.11 (23.97~53.7)127.52 (92.87~166.71)5.41 (3.9~7.22)23.47 (17.92~29.62)
2021年（95%UI）（/10万）25.74 (17.17~36.07)103.86 (75.84~134.66)3.19 (2.24~4.22)17.91 (13.63~21.71)
AAPC（95%CI）(%)-1.18（-1.24~-1.12）-0.66（-0.69~-0.62）-1.70（-2.10~-1.30）-0.87（-0.98~-0.75）
t值-39.70-39.02-8.19-14.93
P值<0.001<0.001<0.001<0.001
DALY率
中国全球
15~49岁
1990年（95%UI）（/10万）18.48 (13.35~25.09)99.09 (79.41~ 120.78)
2021年（95%UI）（/10万）14.43 (10.22~20.46)99.64 (80.88~ 122.53)
AAPC（95%CI）(%)-0.82（-1.05~-0.56）0.02（-0.19~0.23）
t值-6.970.17
P值<0.0010.862
50~69岁
1990年（95%UI）（/10万）131.99 (94.6~172.23)555.88 (433.9~ 681.29)
2021年（95%UI）（/10万）62.95 (43.72~87.66)402.98 (322.48~ 490.94)
AAPC（95%CI）(%)-2.35（-2.52~-2.19）-1.02（-1.16~-0.88）
t值-27.81-13.94
P值<0.001<0.001
≥70岁
1990年（95%UI）（/10万）93.36 (66.22~126.84)385.14 (293.18~ 483.32)
2021年（95%UI）（/10万）51.95 (35.51~70.16)287.94 (216.42~ 350.72)
AAPC（95%CI）(%)-1.89（-2.29~-1.48）-0.95（-1.00~-0.90）
t值-9.04-34.62
P值<0.001<0.001
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1990—2021年中国与全球酒精性肝硬化疾病负担及预测研究
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石呈 1 , 陈旭鹏 1 , 苟莉莉 1 , 蒋玲玲 2 , 官昊宇 2
现代预防医学 | 疾病预防控制 2026,53(4): 747-752
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现代预防医学 |疾病预防控制 2026 , 53 (4) : 747 -752
1990—2021年中国与全球酒精性肝硬化疾病负担及预测研究
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石呈1, 陈旭鹏1, 苟莉莉1, 蒋玲玲2, 官昊宇2
作者信息
  • 1.南京市疾病预防控制中心，江苏 南京 210003
  • 2.南京医科大学附属口腔医院，口腔疾病研究与防治国家级重点实验室培育建设点(南京医科大学)，江苏省口腔转化医学工程研究中心
通讯作者:
官昊宇，E-mail:
作者简介:

石呈（1987—），男，硕士，副主任医师，研究方向：健康教育与健康促进

Disease burden and prediction of alcoholic liver cirrhosis in China and Worldwide, 1990-2021
Cheng SHI1, Xu-peng CHEN1, Li-li GOU1, Ling-ling JIANG2, Hao-yu GUAN2
Affiliations
  • Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China
出版时间: 2026-02-25 doi: 10.20043/j.cnki.MPM.202504185
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摘要
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目的

分析1990至2021年中国与全球酒精性肝硬化疾病负担情况，并预测2022至2050年的疾病负担变化趋势，为我国酒精性肝硬化防控工作提供参考依据。

方法

从2021全球疾病负担（GBD 2021）数据库获取1990—2021年全球和中国酒精性肝硬化在不同性别和年龄分组的患病率、死亡率和DALYs率及其95%不确定区间（95%UI），使用Joinpoint 5.0.1软件计算中国和全球酒精性肝硬化疾病负担的时间趋势，采用嵌套贝叶斯元回归模型预测酒精性肝硬化疾病负担。

结果

中国和全球酒精性肝硬化的标化患病率（AAPC分别为-0.93%和-0.46%）、标化死亡率（AAPC分别为-2.17%和-0.89%）和标化DALY率（AAPC分别为-2.26%和-0.86%）在1990-2021年间均呈下降趋势。中国和全球的男性酒精性肝硬化负担严重程度均高于女性，50岁及以上人群的肝硬化负担严重程度高于15~49岁人群。预测到2050年，中国酒精性肝硬化的标化死亡率为0.68/10万，标化DALY率为20.60/10万；全球酒精性肝硬化的标化死亡率为4.36/10万，标化DALY率为134.70/10万。

结论

我国酒精性肝硬化疾病负担低于全球水平，具有明显的性别差异和年龄差异，建议加强对高危人群的关注，将更多资源用于预防与早期发现，推进健康教育，促进居民形成健康的生活方式。

酒精性肝硬化  /  疾病负担  /  趋势分析
Objective

To analyze the disease burden of alcoholic liver cirrhosis in China and globally from 1990 to 2021, and to predict the trend of burden changes from 2022 to 2050, providing a reference for the prevention and control of alcoholic liver cirrhosis in China.

Methods

Data on the prevalence, mortality, and disability adjusted life years (DALYs) rates of alcoholic liver cirrhosis in different gender and age groups in China and globally from 1990 to 2021, along with their 95% uncertainty intervals (95%UI), were obtained from the Global Burden of Disease (GBD) 2021 database. Joinpoint 5.0.1 software was used to calculate the temporal trends of the disease burden of alcoholic liver cirrhosis in China and globally. The nested Bayesian meta-regression model was employed to predict the burden of alcoholic liver cirrhosis.

Results

The age-standardized prevalence (average annual percent change [AAPC]=-0.93% and -0.46% respectively), age-standardized mortality (AAPC=-2.17% and -0.89% respectively), and age-standardized DALYs rate (AAPC=-2.26% and -0.86% respectively) of alcoholic liver cirrhosis in China and globally showed a downward trend from 1990 to 2021. The burden of alcoholic liver cirrhosis in males was more severe than that in females in both China and globally, and the burden in people aged 50 years and above was more severe than that in those aged 15-49 years. It is predicted that by 2050, the age-standardized mortality rate in China will be 0.68 per 100 000, and the age-standardized DALYs rate will be 20.60 per 100 000; globally, the age-standardized mortality rate will be 4.36 per 100 000, and the age-standardized DALYs rate will be 134.70 per 100 000.

Conclusion

The disease burden of alcoholic liver cirrhosis in China is lower than the global level, with significant gender and age differences. It is recommended to strengthen attention to high-risk groups, allocate more resources to prevention and early detection, promote health education, and encourage residents to adopt healthy lifestyles.

Alcoholic liver cirrhosis  /  Burden of disease  /  Trend analysis
石呈, 陈旭鹏, 苟莉莉, 蒋玲玲, 官昊宇. 1990—2021年中国与全球酒精性肝硬化疾病负担及预测研究. 现代预防医学, 2026 , 53 (4) : 747 -752 . DOI: 10.20043/j.cnki.MPM.202504185
Cheng SHI, Xu-peng CHEN, Li-li GOU, Ling-ling JIANG, Hao-yu GUAN. Disease burden and prediction of alcoholic liver cirrhosis in China and Worldwide, 1990-2021[J]. Modern Preventive Medicine, 2026 , 53 (4) : 747 -752 . DOI: 10.20043/j.cnki.MPM.202504185
正文
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酒精性肝硬化（ALC）是由持续性、大量使用酒精引起酒精性肝病进而发展成的肝硬化，可引起肝、脑、肺、肾等多器官功能障碍，严重影响患者的预后[1-2]。研究表明全球代偿期肝硬化患者估计数量超过一亿人，每年导致约50万人死亡，欧美等发达国家以酒精性肝硬化为主，同时中国人群酒精性肝病的发病率呈上升趋势[3-5]。既往鲜有针对中国与全球酒精性肝硬化疾病负担及预测的相关研究，因此本研究利用2021年全球疾病负担（GBD2021）的研究数据，分析了1990至2021年中国与全球酒精性肝硬化疾病负担情况，并预测2022至2050年的负担变化趋势。为我国酒精性肝硬化防控策略的制定与实施，以及公共卫生政策的调整与优化提供科学的参考依据。
1　资料与方法
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1.1　资料来源
本研究中有关的数据来自2021全球疾病负担研究（GBD 2021）。GBD 2021采用基于人口普查、疾病登记、死因登记和风险因素监测等多种数据来源的统一模型，估算了全球204个国家和地区371种疾病和伤害的发病率、患病率、死亡率和伤残调整生命年（DALYs），具体测算方法详见文献[6]。研究中使用的数据可通过GBD数据输入源工具开放获取（http://ghdx.healthdata.org/gbd-results-tool）。
1.2　疾病负担指标
本研究选取的指标包括1990—2021年全球和中国酒精性肝硬化在不同性别和年龄分组（因15岁前年龄组的疾病负担指标均为0，故不纳入分析）的患病率、死亡率和DALYs率及其95%不确定区间（95%UI），DALY=早死损失寿命年（YLL）+伤残损失寿命年（YLD）。
1.3　疾病分类与编码
采用《国际疾病分类》第十版（ICD-10）对死因数据进行编码。酒精性肝硬化的ICD-10编码范围为K70.0-K70.3。
1.4　统计学方法
使用R 4.1.3和Excel 2019软件进行统计分析和绘图。利用GBD 2021报告的酒精性肝硬化标化患病率、标化死亡率和标化DALY率等指标在1990至2021年间不同性别、不同年龄组中的分布进行分析。采用GBD 2021估计的世界标准人口进行年龄标化。
采用Joinpoint 5.0.1软件计算1990—2021年中国和全球酒精性肝硬化疾病负担的时间趋势。Joinpoint模型通过识别趋势数据中的拐点将长期趋势分成若干个子段，然后在分别评估每个子段的趋势后计算长期趋势，平均年度变化百分比（AAPC）用于评估总体趋势[7]。AAPC>0表示上升趋势，AAPC<0表示下降趋势，P<0.05具有统计学意义。
采用嵌套贝叶斯元回归模型预测酒精性肝硬化负担。根据特定性别、年龄、年份和地区的标化DALY率，结合预测人口，将相应的负担预测至2050年。预测时使用了健康的关键驱动因素，包括社会人口指数（SDI）和涉及的危险因素。SDI是根据25岁以下女性总生育率、15岁及以上人口平均受教育程度和人均收入得到的综合指数。以SDI和时间为主要协变量的混合效应模型对酒精性肝硬化负担进行了建模，因果风险因素的综合效应在模型中用作抵消[8]。
2　结果
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2.1　1990—2021年中国与全球不同性别酒精性肝硬化疾病负担情况及其变化趋势
1990至2021年中国和全球总人群标化患病率分别从12.02/10万下降至9.06/10万和40.23/10万下降至34.81/10万，AAPC分别为-0.93%和-0.46%（P<0.001）。标化死亡率分别从1.23/10万下降至0.63/10万和5.40/10万下降至4.08/10万，AAPC分别为-2.17%和-0.89%（P<0.001）。标化DALY率分别从37.60/10万下降至18.61/10万和167.64/10万下降至128.39/10万，AAPC分别为-2.26%和-0.86%（P<0.001），下降趋势均具有统计学意义。1990和2021年全球男性的标化患病率、标化死亡率和标化DALY率均高于女性，女性的AAPC高于男性，下降趋势均具有统计学意义。见表1，图1。
2.2　1990—2021年中国与全球不同年龄段酒精性肝硬化疾病负担情况及其变化趋势
从年龄分布来看，全球酒精性肝硬化患病率在50~69岁和≥70岁人群的趋势相近，均在1990年为最大值（125.95/10万和127.52/10万），并随年份增长而下降，AAPC分别为-0.63%和-0.66%（P<0.001），而中国的患病率在15~49岁、50~69岁和≥70岁人群中均在1990—2021年间保持相对稳定。全球酒精性肝硬化死亡率在50~69岁和≥70岁人群中均呈现随年份增长而下降，AAPC分别为-1.00%和-0.87%（P<0.001），≥70岁人群的死亡率在各年份中均高于50~69岁人群。相反的是，1990—2021年全球和中国的酒精性肝硬化的DALY率在50~69岁人群的死亡率在各年份中均高于≥70岁人群，并且同年龄组内全球水平均高于中国。见表2和图2。
2.3　预测2022—2050年中国与全球酒精性肝硬化标化死亡率及标化DALY率情况
2022—2050年，中国和全球人群酒精性肝硬化的标化死亡率及标化DALY率均随年份趋于平稳。中国的标化死亡率由2021年的0.63/10万上升至2050年0.68/10万，标化DALY率由2021年的18.61/10万上升至2050年20.60/10万；全球的标化死亡率由2021年的4.08/10万上升至2050年4.36/10万，DALY标化率由2021年的128.39/10万上升至2050年的134.70/10万。见图3。
3　讨论
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本研究基于GBD 2021数据，比较了1990—2021年中国和全球酒精性肝硬化疾病负担的变化趋势，并预测了2022—2050疾病负担的发展情况。研究结果显示，中国和全球酒精性肝硬化的标化患病率、标化死亡率和标化DALY率在1990—2021年间均呈下降趋势。这与全球范围内医疗技术水平的进步密切相关，疾病的预防、治疗策略的优化和良好的疾病管理能力使ALC患者的病情及预后得到了有效改善[9-10]。
长期大量饮酒导致的酒精性肝病在初期通常表现为脂肪肝，进而发展为酒精性肝炎、肝纤维化和肝硬化，失代偿期多脏器功能衰竭导致死亡[11]。研究显示中国酒精性脂肪肝水平低于全球水平。从健康政策角度分析，近年来中国对酒驾、醉驾相关政策的实施以及持续的中央八项规定作风建设极大地影响了公民的饮酒文化和酒精的使用[12]。WTO发布的《2024年全球酒精与健康及药物使用障碍治疗状况报告》显示中国所处的西太平洋地区的人均酒精消费量（9.8升/年）同样低于全球平均水平（12.4升/年）[13]，在全球范围内，亚洲的肝硬化患者中重度酒精使用比例为（0~41%），普遍低于欧洲（16~78%）和美洲（17~52%）[3]，提示低水平的酒精消费与使用降低了中国的酒精性肝硬化疾病负担水平。
从不同性别来看，中国和全球的男性酒精性肝硬化负担严重程度均高于女性水平。可能是因为男性饮酒的频率和饮酒量均高于女性[14]，这与我国的社会发展现状相符。提示在健康干预中应实施性别差异化策略。从不同年龄来看，50及岁以上人群的严重程度高于15~49岁人群，可能与酒精的长期影响、合并基础疾病及肝肾代谢能力下降相关。提示我们应关注中老年人群，医疗卫生部门在相关疾病及酒精滥用的筛查与诊疗中应予以重视。
预测结果显示，至2050年，中国和全球的疾病负担水平将趋于稳定，这反映出在当前干预模式下，负担的下降趋势将显著放缓，现有干预措施的效果可能将接近饱和。假设在未来若没有社会经济、认知水平或治疗技术的重大优化，则亟需制定并实施更为全面和创新的多维度策略，以有效减轻酒精性肝硬化带来的长期负担。需要注意的是新型冠状病毒引起的肺炎疫情的长期影响，疫情期间美国、英国和加拿大等国家的酒精消费量增加[15-17]，这可能会导致若干年内与酒精摄入相关的疾病负担上升[18]。为前瞻性防控酒精危害导致的疾病负担上升风险，进一步降低疾病负担水平，建议国家强化酒精消费管控政策，如通过提高酒精税收与价格、限制酒类广告和促销行为、加强危害知识宣传教育等措施控制过度消费，减少酗酒行为，同时完善酒精滥用监测体系，扎实推进健康中国建设。
本研究同样存在一定的局限性。GBD的数据是基于模型拟合分析得出，尽管数据已覆盖全球几乎所有国家和地区，但仍有一些国家和地区缺乏完整的统计数据。此外，酒精性脂肪肝、肝炎、肝纤维化和肝硬化是一个发展的过程，这可能会导致疾病漏报，尽管GBD 2021采用了严谨的统计方法来解决与实际数据间的不确定性，但仍可能存在潜在的报告偏差，对于获得的结果应谨慎解释。并且GBD中缺乏有关城乡分布的数据，无法分析酒精性肝硬化的城乡差异。最后，本研究的预测模型无法考虑未来医疗和卫生保健政策等外部因素变化的影响。
综上所述，我国酒精性肝硬化疾病负担低于全球水平，但在男性和中老年人群中仍不可小觑。因此建议加强对男性和中老年人群的政策关注，将更多资源用于预防与早期发现。预测显示趋势趋于稳定，未来需要更强力的政策促进负担进一步降低。在健康教育与促进方面，应加强支持性环境建设，引导合理膳食、戒烟限酒，促进居民形成健康的生活方式。
基金
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  • 南京市卫生科技发展项目(GBX22309)
  • 南京医科大学大型科学仪器开放共享研究课题(XZ105Q20200816)
文献
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2026年第53卷第4期
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doi: 10.20043/j.cnki.MPM.202504185
  • 接收时间：2025-04-10
  • 首发时间：2026-11-02
  • 出版时间：2026-02-25
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  • 收稿日期：2025-04-10
基金
南京市卫生科技发展项目(GBX22309)
南京医科大学大型科学仪器开放共享研究课题(XZ105Q20200816)
作者信息
    1.南京市疾病预防控制中心，江苏 南京 210003
    2.南京医科大学附属口腔医院，口腔疾病研究与防治国家级重点实验室培育建设点(南京医科大学)，江苏省口腔转化医学工程研究中心

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
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
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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