1990—2021年中国间质性肺疾病和肺结节病的疾病负担和发展趋势

doi:10.19983/j.issn.2096-8493.20250151

摘要/Abstract

摘要：

目的: 分析1990—2021年中国间质性肺疾病和肺结节病的疾病负担和发展趋势,为制定预防与控制策略提供参考依据。方法: 从全球疾病负担研究数据库中获取1990—2021年中国间质性肺疾病和肺结节病的患病例数和患病率、死亡例数和死亡率、发病例数和发病率以及伤残调整寿命年(disability-adjusted life years,DALYs)和DALYs率。描述1990—2021年中国间质性肺疾病和肺结节病的疾病负担和发展趋势。采用连接点回归分析研究1990—2021年的时间趋势,并预测2022—2040年的发展趋势。结果: 死亡例数从1990年的2955例增至2021年的7674例,死亡率从0.25/10万增至0.54/10万;DALYs总量从1990年的112642人年增至2021年的222288人年,DALYs率从9.57/10万增至15.62/10万;发病例数从1990年的18993例增至2021年的48514例,发病率从1.61/10万增至3.41/10万;患病例数从1990年的254708例增至2021年的628383例,患病率从21.65/10万增至44.17/10万。预测显示,死亡率和DALYs在几乎所有年龄段均下降,发病率和患病率在≥75岁人群均上升。结论: 1990—2021年,中国间质性肺疾病和肺结节病的疾病负担显著加重,关键指标均呈上升趋势,疾病负担向高龄人群集中。

关键词: 肺炎,间质性, 结节病,肺, 疾病负担, 趋势分析

Abstract:

Objective: To analyze the disease burden and trends of interstitial lung disease (ILD) and pulmonary sarcoidosis (PS) in China from 1990 to 2021, and to provide evidence for the development of prevention and control strategies. Methods: With data on the prevalence, mortality, incidence and disability-adjusted life years (DALYs) as well as the relevant rates of ILD and PS in China from 1990 to 2021 available from the Global Burden of Disease Study database, the disease burden and growing trends were described. Joinpoint regression analysis was used to analyze the trends from 1990 to 2021 and to project the trend from 2022 to 2040. Results: The number of deaths increased from 2955 in 1990 to 7674 in 2021, and the mortality rate rose from 0.25 per 100000 to 0.54 per 100000. The total DALYs (disability-adjusted life years) increased from 112642 in 1990 to 222288 in 2021, and the DALYs rate rose from 9.57 per 100000 to 15.62 per 100000. The number of cases increased from 18993 in 1990 to 48514 in 2021, and the incidence rate rose from 1.61 per 100000 to 3.41 per 100000. The number of prevalent cases increased from 254708 in 1990 to 628383 in 2021, and the prevalence rate rose from 21.65 per 100000 to 44.17 per 100000. Projections indicated that mortality rates and DALYs were expected to decline in almost all age groups, while incidence and prevalence rates were projected to rise in the population aged 75 and above. Conclusion: From 1990 to 2021, the disease burden of interstitial lung disease and pulmonary sarcoidosis in China increased significantly, with key indicators showing an upward trend and the burden shifting toward older populations.

Key words: Pneumonia, interstitial, Sarcoidosis, pulmonary, Disease burden, Trend analysis

中图分类号:

R563

曾春梅, 宋畅, 简莎莎, 卢青霞, 刘冬梅, 朱庆东, 赵春艳. 1990—2021年中国间质性肺疾病和肺结节病的疾病负担和发展趋势[J]. 结核与肺部疾病杂志, 2026, 7(2): 186-193. doi: 10.19983/j.issn.2096-8493.20250151

Zeng Chunmei, Song Chang, Jian Shasha, Lu Qingxia, Liu Dongmei, Zhu Qingdong, Zhao Chunyan. Burden and trends of interstitial lung disease and pulmonary sarcoidosis in China from 1990 to 2021[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(2): 186-193. doi: 10.19983/j.issn.2096-8493.20250151

图/表 3

表1

1990—2021年中国ILD和PS的死亡、DALYs、发病和患病变化情况

年份	死亡例数 (95%UI)	死亡率 [/10万 (95%UI)]	DALYs [人年 (95%UI)]	DALYs率 [/10万 (95%UI)]	发病例数 (95%UI)	发病率 [/10万 (95%UI)]	患病例数 (95%UI)	患病率 [/10万 (95%UI)]
1990	2955 (2186~ 4688)	0.25 (0.19~0.40)	112642 (83845~ 167129)	9.57 (7.13~14.21)	18993 (15851~ 22605)	1.61 (1.35~1.92)	254708 (208622~ 309661)	21.65 (17.73~26.32)
1991	3026 (2265~ 4832)	0.25 (0.19~0.41)	115455 (87055~ 168707)	9.68 (7.30~14.14)	19422 (16193~ 23096)	1.63 (1.36~1.94)	261081 (213616~ 317624)	21.89 (17.91~26.63)
1992	3086 (2319~ 4725)	0.26 (0.19~0.39)	121442 (96494~ 169037)	9.75 (7.75~13.58)	19836 (16511~ 23613)	1.64 (1.37~1.96)	267363 (218688~ 325402)	22.17 (18.13~26.98)
1993	3141 (2402~ 4968)	0.26 (0.20~0.41)	120403 (93804~ 170063)	9.76 (7.60~13.78)	20232 (16820~ 24133)	1.66 (1.38~1.98)	273553 (223651~ 333092)	22.47 (18.37~27.36)
1994	3202 (2488~ 4974)	0.26 (0.20~0.41)	117373 (87524~ 167534)	9.73 (7.26~13.89)	20661 (17153~ 24666)	1.68 (1.40~2.01)	280189 (229022~ 341409)	22.85 (18.68~27.84)
1995	3263 (2554~ 5057)	0.26 (0.21~0.41)	120873 (95325~ 166717)	9.75 (7.69~13.45)	21072 (17502~ 25156)	1.71 (1.42~2.04)	286750 (234410~ 349662)	23.24 (19.00~28.34)
1996	3304 (2594~ 5119)	0.27 (0.21~0.41)	119577 (92135~ 168489)	9.75 (7.51~13.74)	21516 (17948~ 25680)	1.74 (1.45~2.07)	293844 (240048~ 358351)	23.70 (19.36~28.90)
1997	3351 (2642~ 5283)	0.27 (0.21~0.42)	118860 (91294~ 168708)	9.76 (7.50~13.86)	21967 (18333~ 26245)	1.76 (1.47~2.11)	301163 (245848~ 367196)	24.19 (19.75~29.49)
1998	3424 (2765~ 5393)	0.27 (0.22~0.43)	122677 (98036~ 170411)	9.82 (7.85~13.64)	22431 (18681~ 26832)	1.80 (1.49~2.15)	308626 (251836~ 376049)	24.70 (20.15~30.09)
1999	3493 (2811~ 5410)	0.28 (0.22~0.43)	123901 (98832~ 174705)	9.88 (7.88~13.93)	22945 (19076~ 27525)	1.83 (1.52~2.19)	316843 (258412~ 385856)	25.26 (20.60~30.77)
2000	3594 (2859~ 5744)	0.29 (0.23~0.46)	125798 (100769~ 178907)	9.99 (8.00~14.21)	23464 (19587~ 28209)	1.86 (1.56~2.24)	324939 (264944~ 395318)	25.81 (21.04~31.40)
2001	3682 (2887~ 5818)	0.29 (0.23~0.46)	127409 (100919~ 177498)	10.07 (7.98~14.03)	24059 (20101~ 28931)	1.90 (1.59~2.29)	333952 (272584~ 406076)	26.40 (21.55~32.10)
2002	3796 (3015~ 5952)	0.30 (0.24~0.47)	130044 (103206~ 181912)	10.23 (8.12~14.31)	24731 (20667~ 29726)	1.95 (1.63~2.34)	343706 (280987~ 417867)	27.04 (22.10~32.87)
2003	3965 (3170~ 6220)	0.31 (0.25~0.49)	133752 (106828~ 187830)	10.46 (8.36~14.70)	25480 (21333~ 30594)	1.99 (1.67~2.39)	354061 (289532~ 430394)	27.70 (22.65~33.67)
2004	4096 (3287~ 6402)	0.32 (0.26~0.50)	141745 (114855~ 192038)	10.96 (8.88~14.85)	26329 (22040~ 31441)	2.05 (1.71~2.45)	365560 (298917~ 444699)	28.44 (23.26~34.60)
2005	4288 (3469~ 6462)	0.33 (0.27~0.50)	136909 (108486~ 188777)	10.65 (8.44~14.69)	27248 (22801~ 32487)	2.11 (1.76~2.51)	377352 (308644~ 460093)	29.19 (23.87~35.59)
2006	4423 (3539~ 6455)	0.34 (0.27~0.50)	146060 (119772~ 193536)	11.22 (9.20~14.87)	28970 (24334~ 34457)	2.23 (1.87~2.65)	395161 (325424~ 480989)	30.37 (25.01~36.96)
2007	4700 (3552~ 6528)	0.36 (0.27~0.50)	153683 (125675~ 198459)	11.73 (9.59~15.14)	31822 (26960~ 37614)	2.43 (2.06~2.87)	420991 (350574~ 510180)	32.12 (26.75~38.93)
2008	5074 (3761~ 6884)	0.38 (0.28~0.52)	163738 (131192~ 206795)	12.41 (9.94~15.67)	35200 (29997~ 41538)	2.67 (2.27~3.15)	450538 (377511~ 541543)	34.13 (28.60~41.03)
2009	5441 (3961~ 7005)	0.41 (0.30~0.53)	173395 (134693~ 213072)	13.05 (10.14~16.03)	38426 (32829~ 45421)	2.89 (2.47~3.42)	479789 (401004~ 574657)	36.10 (30.17~43.24)
2010	5719 (4013~ 7241)	0.43 (0.30~0.54)	180162 (140029~ 223168)	13.48 (10.47~16.69)	40558 (34703~ 47944)	3.03 (2.60~3.59)	501068 (421006~ 598001)	37.48 (31.49~44.73)
2011	5967 (4127~ 7533)	0.44 (0.31~0.56)	185989 (143921~ 230868)	13.84 (10.71~17.18)	41704 (35786~ 49218)	3.10 (2.66~3.66)	515605 (434186~ 614762)	38.37 (32.31~45.75)
2012	6144 (4029~ 7677)	0.45 (0.30~0.57)	189992 (144041~ 229997)	14.06 (10.66~17.02)	42570 (36545~ 50214)	3.15 (2.70~3.72)	527491 (444921~ 628184)	39.04 (32.93~46.49)
2013	6369 (4217~ 8036)	0.47 (0.31~0.59)	194361 (147195~ 239088)	14.30 (10.83~17.59)	43255 (37105~ 51024)	3.18 (2.73~3.75)	537461 (453640~ 639184)	39.54 (33.37~47.02)
2014	6472 (4106~ 8414)	0.47 (0.30~0.62)	196533 (146866~ 243437)	14.37 (10.74~17.80)	43860 (37568~ 51557)	3.21 (2.75~3.77)	547522 (463184~ 650105)	40.03 (33.86~47.53)
2015	6579 (4183~ 8379)	0.48 (0.30~0.61)	198782 (146288~ 249554)	14.43 (10.62~18.12)	44470 (38100~ 52181)	3.23 (2.77~3.79)	557188 (472913~ 660608)	40.45 (34.33~47.96)
2016	6753 (4163~ 8725)	0.49 (0.30~0.63)	202223 (149889~ 255861)	14.57 (10.80~18.44)	44995 (38528~ 52651)	3.24 (2.78~3.79)	566708 (482306~ 670645)	40.83 (34.75~48.32)
2017	6911 (4331~ 9127)	0.49 (0.31~0.65)	205348 (148701~ 269214)	14.69 (10.64~19.25)	45353 (38796~ 52855)	3.24 (2.77~3.78)	574444 (490272~ 678423)	41.09 (35.07~48.52)
2018	7043 (4250~ 9217)	0.50 (0.30~0.65)	208283 (151591~ 266730)	14.80 (10.77~18.96)	45747 (39193~ 53219)	3.25 (2.79~3.78)	582696 (498402~ 685694)	41.41 (35.42~48.73)
2019	7227 (4583~ 9866)	0.51 (0.32~0.70)	212312 (156898~ 279492)	15.01 (11.09~19.76)	46390 (39753~ 53713)	3.28 (2.81~3.80)	594781 (508702~ 696825)	42.05 (35.97~49.27)
2020	7439 (4344~ 9775)	0.52 (0.31~0.69)	216654 (151600~ 278932)	15.26 (10.68~19.65)	47335 (40592~ 54682)	3.33 (2.86~3.85)	609838 (522126~ 717703)	42.96 (36.78~50.56)
2021	7674 (4637~ 10371)	0.54 (0.33~0.73)	222288 (158551~ 288301)	15.62 (11.14~20.26)	48514 (41541~ 55949)	3.41 (2.92~3.93)	628383 (534993~ 737822)	44.17 (37.60~51.86)
EAPC(%, 95%CI)	3.48 (3.27~3.69)	2.87 (2.67~3.08)	2.48 (2.28~2.68)	1.88 (1.68~2.08)	3.58 (3.29~3.87)	2.98 (2.69~3.27)	3.24 (3.07~3.40)	2.64 (2.47~2.80)

表1

图1

图2

参考文献 18

[1]	李修泽, 王静, 邢颜平, 等. 不同类型间质性肺疾病患者临床特征和肿瘤标志物水平及其发生肺癌影响因素. 临床误诊误治, 2025, 38(1): 30-34.doi:10.3969/j.issn.1002-3429.2025.01.008.
[2]	Belperio JA, Shaikh F, Abtin FG, et al. Diagnosis and Treatment of Pulmonary Sarcoidosis: A Review. JAMA, 2022, 327(9): 856-867. doi:10.1001/jama.2022.1570. pmid: 35230389
[3]	Wang F, Ma B, Ma Q, et al. Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030. Int J Surg, 2024, 110(4): 1951-1967. doi:10.1097/JS9.0000000000001071. pmid: 38265437
[4]	Xu Y, Gong M, Wang Y, et al. Global trends and forecasts of breast cancer incidence and deaths. Sci Data, 2023, 10(1): 334. doi:10.1038/s41597-023-02253-5. pmid: 37244901
[5]	GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990—2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2133-2161. doi:10.1016/S0140-6736(24)00757-8.
[6]	Liu X, Yang Q, Pan L, et al. Burden of respiratory tract cancers in China and its provinces, 1990—2021: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Reg Health West Pac,2025, 55:101485. doi:10.1016/j.lanwpc.2025.101485.
[7]	Wang L, Lv H, Zhang X, et al. Global prevalence, burden and trend in HIV and drug-susceptible tuberculosis co-infection from 1990 to 2019 and prediction to 2040. Heliyon, 2024, 10(1): e23479. doi:10.1016/j.heliyon.2023.e23479.
[8]	Hankey BF, Ries LA, Kosarey CL, et al. Partitioning linear trends in age-adjusted rates. Cancer Causes Control, 2000, 11(1): 31-35. doi:10.1023/a:1008953201688.
[9]	Lin C, An H, Lin J, et al. Comparison of incidence trends of early-onset and late-onset type 2 diabetes in the Asia-Pacific region, 1990—2021: a join point regression analysis based on the global burden of disease study 2021. Frontiers in endocrinology, 2025, 16: 1466428. doi:10.3389/fendo.2025.1466428.
[10]	Xu H, Xiao W, Ding C, et al. Global burden of osteoarthritis among postmenopausal women in 204 countries and territories: a systematic analysis for the Global Burden of Disease Study 2021. BMJ global health, 2025, 10(3):e017198. doi:10.1136/bmjgh-2024-017198.
[11]	Gandhi S, Tonelli R, Murray M, et al. Environmental Causes of Idiopathic Pulmonary Fibrosis. Int J Mol Sci, 2023, 24(22):16481. doi:10.3390/ijms242216481.
[12]	GBD 2019 Tobacco Collaborators. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990—2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet,2021, 397(10292):2337-2360. doi:10.1016/S0140-6736(21)01169-7.
[13]	Wijsenbeek M, Suzuki A, Maher TM. Interstitial lung diseases. Lancet, 2022, 400(10354): 769-786. doi:10.1183/09059180.00009113.
[14]	Chen S, Li Y. Global health inequalities in the burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2021. BMC Public Health, 2024, 24(1): 2892. doi:10.1186/s12889-024-20430-y. pmid: 39511538
[15]	Cerro Chiang G, Parimon T. Understanding Interstitial Lung Diseases Associated with Connective Tissue Disease (CTD-ILD): Genetics, Cellular Pathophysiology, and Biologic Drivers. Int J Mol Sci, 2023, 24(3):2405. doi:10.3390/ijms24032405.
[16]	Kim Y, Yang HI, Kim KS. Etiology and Pathogenesis of Rheumatoid Arthritis-Interstitial Lung Disease. Int J Mol Sci, 2023, 24(19):14509. doi:10.3390/ijms241914509.
[17]	Mylvaganam R, Dua S, Nelson-piercy C, et al. Interstitial Lung Disease in Women of Child-Bearing Age. Semin Respir Crit Care Med, 2017, 38(2): 185-190. doi:10.1055/s-0037-1602243. pmid: 28561249
[18]	郑荣寿, 陈万青. 基于贝叶斯方法的年龄-时期-队列预测模型的介绍. 中华预防医学杂志, 2012, 46(7): 648-650. doi:10.3760/cma.j.issn.0253-9624.2012.07.016.