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结核与肺部疾病杂志 ›› 2026, Vol. 7 ›› Issue (3): 349-355.doi: 10.19983/j.issn.2096-8493.20250213

• 论著 • 上一篇    下一篇

中国结核病疾病负担及归因风险因素与预测

马建军1, 张铁娟2, 于世晖1, 翟前前3, 姚来顺4, 黄飚5()   

  1. 1 吉林省结核病防治科学研究院诊疗质量评价所, 长春 130062
    2 吉林省疾病预防控制中心专家室, 长春 130062
    3 吉林省疾病预防控制中心(吉林省预防医学科学院)应急办公室, 长春 130062
    4 吉林省结核病防治科学研究院办公室, 长春 130062
    5 吉林省疾病预防控制中心(吉林省预防医学科学院)办公室, 长春 130062
  • 收稿日期:2026-01-07 出版日期:2026-06-20 发布日期:2026-06-12
  • 通信作者: 黄飚 E-mail:Huangbiao2000@sohu.com
  • 基金资助:
    吉林省传染病防控快速反应机制研究(JL2026-14);2024年国家疾病预防控制局公共卫生人才培养支持项目

Burden, attributable risk factors, and projection of tuberculosis in China

Ma Jianjun1, Zhang Tiejuan2, Yu Shihui1, Zhai Qianqian3, Yao Laishun4, Huang Biao5()   

  1. 1 Department of Quality Evaluation in Diagnosis and Treatment, Jilin Provincial Tuberculosis Prevention and Control Research Institute, Changchun 130062, China
    2 Expert Office of Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
    3 Emergency Office of the Jilin Provincial Center for Disease Control and Prevention (Jilin Provincial Academy of Preventive Medicine), Changchun 130062, China
    4 Office of Jilin Provincial Institute of Tuberculosis Prevention and Control, Changchun 130062, China
    5 Office of Jilin Provincial Center for Disease Control and Prevention (Jilin Provincial Academy of Preventive Medicine), Changchun 130062, China
  • Received:2026-01-07 Online:2026-06-20 Published:2026-06-12
  • Contact: Huang Biao E-mail:Huangbiao2000@sohu.com
  • Supported by:
    Research on the Rapid Response Mechanism for Infectious Disease Prevention and Control in Jilin Province(JL2026-14);2024 National Disease Control and Prevention Administration Talent Development Support Program

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摘要：

目的: 分析2000—2021年中国结核病疾病负担及归因风险因素,预测2022—2035年中国结核病疾病负担,为制定我国公共卫生政策提供参考。方法: 利用2021年全球疾病负担(global burden of disease, GBD)数据,采用年龄标化发病率(age-standardized incidence rate,ASIR)、标化死亡率(age-standardizedmortality rate,ASMR)、标化伤残调整生命年率(age-standardizeddisability adjusted life years rate,ASDR)评估中国结核病疾病负担,分析性别、年龄对结核病负担的影响,使用Joinpoint回归模型研究疾病负担变化趋势并进行Mann-Kendall 趋势检验,应用自回归移动平均模型(autoregressive integrated moving average model,ARIMA)预测2022—2035年中国结核病疾病负担,使用平均绝对误差百分比(MAPE)、平均绝对误差(MAE)和均方根误差(RMSE)指标评价模型,分析吸烟、饮酒、高血糖的归因风险趋势。结果: 2000—2021年中国结核病ASIR、ASMR、ASDR呈下降趋势,2021年中国结核病ASIR(36.28/10万)、ASMR(1.91/10万)、ASDR(76.22/10万)比2000年中国结核病ASIR(79.15/10万)、ASMR(10.30/10万)、ASDR(374.96/10万)分别下降了54.16%、81.46%、79.67%。2021年中国60岁以上结核病患者比例(41.77%)比2000年(29.25%)上升了42.80%,2021年85岁以上发病性别差异贡献最大(19.3%)。预测2022—2035年ASIR、ASMR、ASDR呈下降趋势,2035年ASIR、ASMR、ASDR分别为17.38/10万、0.65/10万、14.35/10万。2000—2021年吸烟归因占比先上升后趋于平稳(2000年中国吸烟归因占比为21%,2014年中国吸烟归因占比为26%,2021年中国吸烟归因占比为25%),饮酒归因占比持续稳定上升(2000年中国饮酒归因占比为12%,2021年中国饮酒归因占比为18%),高血糖归因占比先上升后下降(2000年中国高血糖归因占比为8%,2015年中国高血糖归因占比为10%,2021年中国高血糖归因占比为9%);2021年男性吸烟归因占比最高(34%)。结论: 2000—2021年中国结核病疾病负担显著下降,男性和老年人的疾病负担较高,男性吸烟归因贡献大,饮酒归因占比持续稳定上升,应强化控烟政策,改变个人的不良生活方式,针对老年及男性实施精准防控。

关键词: 结核, 疾病负担, 模型, 统计学, 流行病学研究

Abstract:

Objective: With analyzing the burden and attributable risk factors of tuberculosis (TB) in China from 2000 to 2021, and projecting the disease burden from 2022 to 2035, to provide evidence for the formulation of public health policies. Methods: With data from the Global Burden of Disease Study 2021 (GBD 2021), the TB burden in China was assessed using age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rate (ASDR). We analyzed the impact of gender and age on TB burden, adopted the Joinpoint regression model for the changing trend and conducted the Mann-Kendall trend tests. The Autoregressive Integrated Moving Average (ARIMA) model was applied to project the TB burden from 2022 to 2035, with model performance evaluated using the mean absolute percentage error (MAPE), mean absolute error (MAE), and root mean square error (RMSE). Trends in risk factors attributable to smoking, alcohol use, and high fasting plasma glucose were also analyzed. Results: From 2000 to 2021, China observed a downward trend in ASIR, ASMR, and ASDR for TB. By 2021, the ASIR (36.28 per 100000), ASMR (1.91 per 100000), and ASDR (76.22 per 100000) decreased by 54.16%, 81.46%, and 79.67% respectively compared with the ASIR (79.15 per 100000), ASMR (10.30 per 100000), and ASDR (374.96 per 100000) in 2000. The proportion of TB patients aged 60 and above in China in 2021 (41.77%) increased by 42.80% compared with that in 2000 (29.25%).The male-to-female ratio across age groups showed an increasing annual trend, with the >85 age group contributing the most to the sex disparity in 2021 (19.3%). Projections for 2022—2035 indicated a continuous decline, with ASIR, ASMR, and ASDR estimated to reach 17.38, 0.65, and 14.35 per 100000 by 2035, respectively. Regarding risk factors, the proportion attributable to smoking initially rose and then stabilized, with the proportion attributable to smoking 21% in 2000, 26% in 2014, and 25% in 2021.While the proportion attributable to alcohol use showed a steady and continuous increase, with 12% in 2000 and 18% in 2021.The proportion attributable to high fasting plasma glucose initially increased and then declined, with 8% in 2000, 10% in 2015, and 9% in 2021. Smoking in males accounted for the highest attributable proportion (34%) in 2021. Conclusion: Although the burden of TB in China declined significantly from 2000 to 2021, it remains relatively high among males and the elderly. Given the high contribution of smoking in males and the steady rise in alcohol-attributable burden, public health strategies should prioritize strengthening tobacco control and promoting healthy lifestyles. Targeted prevention and control measures focusing on the elderly and male populations are essential.

Key words: Tuberculosis, Disease burden, Models, statistical, Epidemiologic studies

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