1990—2019 年中国龋病的疾病负担现状及变化趋势研究
背景 龋病是常见的非传染性疾病之一，影响着全球三分之一以上的人口，分析其疾病负担现状及变化趋势能够为龋病的防治策略提供一定的参考价值。目的 分析中国龋病的发病、患病和伤残损失寿命年（YLD）现状及变化趋势，为我国制订龋病防治策略提供参考依据。方法 提取 2019 年全球疾病负担（GBD）研究中 1990—2019 年中国乳牙龋病和恒牙龋病的发病、患病和 YLD 数据，计算 1990—2019 年中国乳牙龋病和恒牙龋病的发病人次、患病人数和 YLD 人年数的变化百分比，并应用 Joinpoint 回归模型分析 1990—2019 年中国乳牙龋病和恒牙龋病的年龄标准化发病率、患病率和 YLD 率的年度变化百分比（APC）与平均年度变化百分比（AAPC）。结果 与 1990 年相比，2019 年中国乳牙龋病的发病人次、患病人数和 YLD 人年数分别减少了 25.69%、28.74% 和 28.63%；恒牙龋病的发病人次、患病人数和 YLD 人年数分别增加了 17.41%、15.84% 和 15.07%。2019 年，在各年龄组中，5~9 岁儿童乳牙龋病发病率（118.96%）最高，1~4 岁儿童乳牙龋病患病率（53.08%）和 YLD 率（20.40/10 万）最高；20~24 岁成人恒牙龋病的发病率（62.30%）、患病率（32.19%）和 YLD 率（32.41/10 万）均最高。Joinpoint 回归模型结果显示：1990—2019 年，中国乳牙龋病的年龄标准化发病率（AAPC=0.21%，95%CI=0.19%~0.22%）、患病率（AAPC=0.03%，95%CI=0.01%~0.05%）和 YLD 率（AAPC=0.03%，95%CI=0.01%~0.05%）整体呈上升趋势；恒牙龋病的年龄标准化发 病 率（AAPC=-0.05%，95%CI=-0.05%~-0.04%）、 患 病 率（AAPC=-0.23%，95%CI=-0.32%~-0.14%） 和 YLD 率（AAPC=-0.22%，95%CI=-0.31%~-0.13%）整体呈下降趋势。结论 中国 1990—2019 年乳牙龋病疾病负担呈现出加重趋势，尽管恒牙龋病的疾病负担有所下降但依旧严峻，预防龋病不能仅仅局限于儿童，而应该包括所有年龄段人群。
Background Dental caries is one of the common noncommunicable diseases worldwideaffecting more than one-third of the global population. The analysis of the current situation and trends in the disease burden of dental caries may provide reference for the prevention and control strategies of dental caries. Objective To analyze the current situation and trends in the incidenceprevalence and years lived with disabilityYLD of dental caries in China and provide reference for the development of the prevention and control of dental caries. Methods Data on the incidenceprevalence and YLD of caries of deciduous teeth and permanent teeth between 1990 and 2019 in China were extracted from the 2019 Global Burden of DiseaseGBD study. The percentage change in the counts of incident casesprevalent cases and YLD of caries of deciduous teeth and permanent teeth from 1990 to 2019 was calculatedand Joinpoint regression model was used to analyze the annual percentage changeAPC and average APCAAPC in age-standardized rates of incidenceprevalence and YLD between 1990 and 2019 in China. Results Compared with 1990the counts of incident casesprevalent cases and YLD of caries of deciduous teeth in China in 2019 decreased by 25.69%28.74% and 28.63%respectively the counts of incident casesprevalent cases and YLD of caries of permanent teeth in China in 2019 increased by 17.41%15.84% and 15.07%respectively. In all age groups in 2019the highest incidence rate118.96% of caries of deciduous teeth was observed in children aged 5 to 9 yearsas well as the highest prevalence rate53.08% and YLD rate20.40/100000 of caries of deciduous teeth in children aged 1 to 4 years. The highest incidence rate62.30%prevalence rate32.19%and YLD rate32.41/100 000 of caries of permanent teeth were observed in adults aged 20 to 24 years in 2019. Joinpoint regression analysis showed that the agestandardized rates of incidenceAAPC=0.21%95%CI=0.19% to 0.22%prevalenceAAPC=0.03%95%CI=0.01% to 0.05% and YLDAAPC=0.03%95%CI=0.01% to 0.05% of caries of deciduous teeth showed an overall upward trend in China between 1990 and 2019and the age-standardized rates of incidenceAAPC=-0.05% to 95%CI=-0.05% to -0.04%prevalenceAAPC=-0.23%95%CI=-0.32% to -0.14% and YLDAAPC=-0.22%95%CI=-0.31% to -0.13% of caries of permanent teeth showed a downward trend in China between 1990 and 2019. Conclusion From 1990 to 2019the burdens in caries of deciduous teeth in China showed an increasing trendwhile the burdens in caries of permanent teeth caries showed a decreasing trend but remained serious in China. Caries prevention should not only be limited to childrenbut should include people of all age groups.
黄港 1，曹桂莹 2，刘民 2，3*
口腔科学预防医学医学研究方法
乳牙龋病恒牙龋病牙科生理学现象Joinpoint 回归模型2019 全球疾病负担研究
黄港 1，曹桂莹 2，刘民 2，3*.1990—2019 年中国龋病的疾病负担现状及变化趋势研究[EB/OL].(2023-11-29)[2025-08-11].https://chinaxiv.org/abs/202312.00012.点此复制
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