摘要：
目的：分析1990年和2010年中国人群伤害疾病负担及变化趋势。方法利用2010年全球疾病负担研究结果，主要指标包括死亡率、过早死亡损失寿命年（YLL)、伤残损失寿命年（YLD)和伤残调整寿命年（DALY)，描述中国人群伤害的疾病负担现状。同时，以2010年人口普查数据作为标准人口，将每5岁作为1个年龄组，计算了标化死亡率，标化的YLL率、YLD率和DALY率，分析1990年到2010年的变化幅度，描述疾病负担指标20年的变化趋势。结果2010年中国人群因伤害死亡796240例，伤害死亡率为59.34/10万，标化死亡率为61.87/10万；伤害造成的YLL为3175.93万人年， YLD为904.47万人年，DALY为4080.40万人年。中国人群前5位伤害死因依次为道路交通事故、自杀、意外跌倒、溺水、意外中毒，2010年因这5种伤害导致的死亡人数依次是282576、172964、115294、67402、36997例。按DALY负担排序，前5位伤害依次是道路交通事故、意外跌倒、自杀、溺水、意外中毒，导致的DALY依次为1496.23万、705.83万、596.99万、366.34万、161.37万人年。道路交通事故造成的疾病负担上升迅速，标化死亡率从1990年15.76/10万上升到2010年21.83/10万，上升了38.54%，标化DALY率从1990年的930.12/10万上升到2010年的1142.19/10万，上升了22.80%；自杀导致的疾病负担呈现下降趋势，标化死亡率从1990年的22.62/10万下降到2010年的13.62/10万，下降了39.82%，标化DALY率从1990年的875.09/10万下降到了2010年的462.28/10万，下降了47.17%。伤害DALY负担最高的年龄段是20～24岁，其次是40～44岁、35～39岁，3个年龄组的DALY依次为422.11万、416.55万、403.19万人年。结论伤害是导致中国人群疾病负担的重要疾病，尤其危害青壮年人群。近年来，道路交通事故疾病负担上升迅速。要针对道路交通事故、意外跌倒、自杀等重点伤害，采取针对性的防控措施。%Objective To analyze the status and trend of injury burden in 1990 and 2010 for Chinese people. Methods We used results of the Global Burden of Diseases Study 2010(GBD 2010) to analyze the status of injury burden in China. The main outcome measurements included years of life lost (YLL), years lived with disability(YLD), and disability-adjusted life years(DALY). Moreover,the China Census in 2010 was used as the reference population to calculate the age-standardized rate with each five-year as an age group. We also calculate the percentage change from 1990 to 2010 and analyze the trend of injury burden in China for the past twenty years. Results In 2010, a total of 796 240 people died of injury. The crude death rate of injury in China was 59.34/100 000 and the standardized death rate was 61.87/100 000;the YLL due to injury was 31.7593 million person years. The YLD due to injury was 9.0447 million person years and the DALY due to injury was 40.8040 million person years. In 2010, the top five causes of death related to injury were road traffic, injury, suicide, falls, drowning and poisoning. The death number for the five causes were 282 576, 172 964, 115 294, 67 402,and 36 997,respectively. The top five causes of DALY related to injury were road traffic injury, falls, suicide, drowning and poisoning and the DALY were 14.9623 million, 7.0583 million, 5.9699 million, 3.6634 million,and 1.6137 million person years. From 1990 to 2010, the burden attributable to road traffic injury increased quickly, the standardized death rate increased from 15.76/100 000 to 21.83/100 000, up 38.54%; the standardized DALY rate increased from 930.12/100 000 to 1142.19/100 000, up 22.80%. From 1990 to 2010, the burden attributable to suicide decreased, the standardized death rate decreased from 22.62/100 000 to 13.62/100 000, down 39.82%, and the standardized DALY rate decreased from 875.09/100 000 to 462.28/100 000, down 47.17%. The disease burden of injury topped at the group aged 20-24, followed by group aged 40-44 and group aged 35-39,the DALY for the three age groups were 4.2211 million,4.1655 million,and 4.0319 million person years, respectively. Conclusion Injury was the main disease for burden among Chinese population, especially among young adults. In recent years, the burden attributable to road traffic injury increased quickly.Targeted prevention and control measures for road traffic injury, falling, suicide and other key injury should be in place to reduce the burden of injury effectively.
