中国胃炎和十二指肠炎疾病负担的长期演变、效应解析与未来态势：基于GBD 2023的分析

doi:10.19723/j.issn.1671-167X.2026.04.021

摘要/Abstract

摘要：

目的: 探究1990—2023年中国胃炎和十二指肠炎(gastritis and duodenitis，GD)的疾病负担演变趋势，明确其负担变化的驱动要素，预测2024—2040年疾病负担态势，为GD防控策略的制定提供数据依据。方法: 依托全球疾病负担研究2023的数据，运用Joinpoint回归模型剖析1990—2023年中国GD年龄标准化(简称标化)发病率、标化患病率、标化死亡率及标化伤残调整寿命年(disability-adjusted life year，DALY)率的平均年度百分比变化(ave-rage annual percent change，AAPC)；通过年龄-时期-队列模型探究年龄、时期、队列三效应对发病、患病及死亡风险的作用；分辨人口结构变化、流行病学变化、人口增长三类因素对疾病负担的驱动效应；运用自回归积分滑动平均(autoregressive integrated moving average，ARIMA)模型展望未来疾病负担。结果: 1990—2023年，中国GD发病例数由615.88万上升至935.45万，患病例数由877.06万上升至1 314.59万，死亡例数由1.98万降至1.72万，DALY数由90.24万人年微降至85.16万人年；标化发病率、标化患病率、标化死亡率及标化DALY率的AAPC分别为-1.08%、-1.18%、-3.81%、-2.89%(均P＜0.001)。Joinpoint回归分析表明，各标化率均呈分阶段下降趋势。年龄-时期-队列模型显示，发病与患病风险在55~59岁达峰，死亡风险随年龄升高显著上升；发病与患病风险时期效应先升后降，死亡风险时期效应持续下降；队列风险均呈下降趋势。分解研究表明，人口增长与结构变化促使发病数、患病数增加(发病数总体贡献占比分别为165.66%、167.00%)，流行病学变化为其下降主因(发病数总体贡献占比-232.66%)；流行病学变化是死亡数下降的核心因素(总体贡献占比490.07%)。ARIMA模型预测显示，至2040年发病数将升至1 108.61万例，患病数升至1 527.96万例，死亡率降至0.48/10万，DALY率降至26.18/10万。结论: 1990—2023年中国GD标化疾病负担明显缓解，人口因素与流行病学变化协同推动负担变化；未来发病与患病数将上升，但死亡与伤残负担持续降低，需结合年龄、队列特征及驱动因素制定精准防控策略。

关键词: 胃炎, 十二指肠炎, 全球疾病负担, 中国

Abstract:

Objective: To explore the evolutionary trends of the disease burden of gastritis and duodenitis (GD) in China from 1990 to 2023, to clarify the driving factors of changes in this burden, to predict the disease burden situation from 2024 to 2040, and to provide data support for formulating GD prevention and control strategies. Methods: Based on the Global Burden of Disease Study (GBD) 2023 data, the Joinpoint regression model was applied to analyze the annual average percentage change (AAPC) of age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized disability-adjusted life years (DALY) rate of GD in China from 1990 to 2023. The age-period-cohort model was used to investigate the effects of age, period, and cohort on incidence, prevalence, and mortality risks. Three factors—population structure change, epidemiological change, and population growth—were identified to determine their driving effects on the disease burden. The auto-regressive integrated moving average (ARIMA) time series model was employed to forecast the future disease burden. Results: From 1990 to 2023, the number of GD incident cases in China increased from 6.158 8 million to 9.354 5 million, the number of prevalent cases rose from 8.770 6 million to 13.145 9 million, the number of deaths decreased from 19 800 to 17 200, and the number of DALY slightly declined from 902 400 person-years to 851 600 person-years. The AAPCs of age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized DALY rate were -1.08%, -1.18%, -3.81%, and -2.89%, respectively (all P < 0.001). Joinpoint regression analysis showed that all age-standardized rates presented a phased downward trend. Age-period-cohort model analysis revealed that the incidence and prevalence risks peaked in the 55-59 years age group, while the mortality risk increased significantly with age. The period effect of incidence and prevalence risks first increased and then decreased, whereas the period effect of mortality risk showed a conti-nuous downward trend; the cohort risk exhibited a decreasing trend across all the groups. Decomposition analysis indicated that population growth and structural change promoted the increase in incident and prevalent cases (the overall contribution rates to the incident cases were 165.66% and 167.00%, respectively), while epidemiological change was the main factor driving their decrease (with an overall contribution rate of -232.66% to the incident cases). Additionally, epidemiological change was the core factor for the reduction in deaths (with an overall contribution rate of 490.07%). The ARIMA time series model predicted that by 2040, the number of incident cases would rise to 11.086 1 million, the number of prevalent cases to 15.279 6 million, the mortality rate to 0.48 per 100 000 population, and the DALY rate to 26.18 per 100 000 population. Conclusion: From 1990 to 2023, the age-standardized disease burden of GD in China was significantly alleviated, with population factors and epidemiological changes jointly driving the burden changes. Although the number of incident and prevalent cases will increase in the future, the mortality and disability burden will continue to decrease. It is necessary to formulate targeted prevention and control strategies based on age, cohort characteristics, and driving factors.

Key words: Gastritis, Duodenitis, Global burden of disease, China

中图分类号:

R573

王清华, 沈天天, 卢晓微, 廖聪聪, 许石伟, 李琰. 中国胃炎和十二指肠炎疾病负担的长期演变、效应解析与未来态势：基于GBD 2023的分析[J]. 北京大学学报（医学版）, 2026, 58(4): 833-841.

Qinghua WANG, Tiantian SHEN, Xiaowei LU, Congcong LIAO, Shiwei XU, Yan LI. Long-term evolution, effect analysis and future trend of the burden of gastritis and duodenitis in China: An analysis based on GBD 2023[J]. Journal of Peking University (Health Sciences), 2026, 58(4): 833-841.

图/表 6

表1

1990年和2023年中国GD疾病负担对比"

Indicator	1990			2023
Indicator	Total	Male	Female	Total	Male	Female
Incidence
Incident cases/(×10⁴)	615.88(480.19-794.52)	292.77(228.67-377.46)	323.11(252.22-415.37)	935.45(729.09-1 182.95)	407.40(319.33-507.83)	528.04(410.28-675.16)
Incidence rate/(per 10⁵)	838.88(654.06-1 082.20)	777.12(606.96-1 001.89)	903.98(705.67-1 162.10)	851.98(664.03-1 077.39)	733.95(575.29-914.87)	972.65(755.74-1 243.63)
Age-standardized incidence rate/(per 10⁵)	700.22(551.64-874.14)	650.80(513.11-810.21)	750.13(592.28-940.96)	489.05(391.66-599.60)	437.47(349.09-529.29)	541.46(430.51-669.24)
Prevalence
Prevalent cases/(×10⁴)	877.06(674.68-1 108.67)	414.01(321.48-525.19)	463.05(355.15-584.33)	1 314.59(1 034.83-1 636.95)	559.05(445.26-687.11)	755.54(595.71-945.24)
Prevalence rate/(per 10⁵)	1 194.62(918.97-1 510.08)	1 098.90(853.32-1 394.02)	1 295.51(993.63-1 634.80)	1 197.28(942.49-1 490.87)	1 007.14(802.15-1 237.84)	1 391.69(1 097.30-1 741.12)
Age-standardized prevalence rate/(per 10⁵)	1 004.91(793.38-1 230.01)	929.54(738.53-1 142.69)	1 080.74(843.31-1 317.66)	678.98(544.78-821.73)	597.67(488.01-720.55)	761.24(606.68-923.71)
Death
Number of deaths/(×10⁴)	1.98(1.17-3.28)	1.05(0.44-2.05)	0.92(0.43-1.59)	1.72(1.03-2.31)	0.94(0.46-1.40)	0.78(0.48-1.06)
Mortality rate/(per 10⁵)	2.70(1.59-4.47)	2.80(1.17-5.45)	2.59(1.21-4.46)	1.57(0.94-2.11)	1.70(0.84-2.52)	1.45(0.89-1.97)
Age-standardized mortality rate/(per 10⁵)	3.02(1.78-5.02)	3.27(1.38-6.12)	2.73(1.28-4.74)	0.81(0.49-1.08)	0.96(0.48-1.38)	0.67(0.42-0.92)
DALY
DALY/(×10⁴ person-years)	90.24(61.53-134.31)	47.11(28.11-77.23)	43.13(26.52-62.51)	85.16(63.32-114.63)	41.49(28.44-54.89)	43.66(31.83-60.17)
DALY rate/(per 10⁵)	122.92(83.82-182.95)	125.05(74.62-205.01)	120.69(74.21-174.89)	77.56(57.67-104.41)	74.75(51.25-98.89)	80.44(58.65-110.83)
Age-standardized DALY rate/(per 10⁵)	118.19(81.26-173.20)	122.01(74.15-195.68)	113.87(71.70-163.06)	43.51(31.87-58.47)	43.58(29.97-57.48)	43.55(31.14-60.58)

表1

图1

表2

1990—2023年中国GD标化率的Joinpoint分析"

Items	Trend stage	Total		Male		Female
Items	Trend stage	Year	APC/%	Year	APC/%	Year	APC/%
Age-standardized incidence rate	1	1990-1995	-0.94^*(-1.13 to -0.77)	1990-2005	-0.61^*(-0.63 to -0.59)	1990-1994	-1.49^*(-1.61 to -1.39)
	2	1995-2005	-0.21^*(-0.28 to -0.14)	2005-2010	-4.42^*(-4.55 to -4.29)	1994-2003	0.04^*(0.01 to 0.09)
	3	2005-2010	-4.02^*(-4.25 to -3.80)	2010-2015	-0.46^*(-0.60 to -0.34)	2003-2006	-0.44^*(-0.78 to -0.11)
	4	2010-2023	-0.64^*(-0.68 to -0.61)	2015-2020	-1.02^*(-1.15 to -0.90)	2006-2009	-4.92^*(-5.24 to -4.60)
	5			2020-2023	-0.05 (-0.27 to 0.15)	2009-2012	-1.22^*(-1.56 to -0.90)
	6					2012-2015	-0.29 (-0.62 to 0.04)
	7					2015-2023	-0.74^*(-0.78 to -0.71)
Age-standardized prevalence rate	1	1990-1994	-1.29^*(-1.49 to -1.11)	1990-2000	-0.82^*(-0.89 to -0.77)	1990-1994	-1.56^*(-1.76 to -1.37)
	2	1994-2000	-0.49^*(-0.63 to -0.36)	2000-2005	-0.01 (-0.24 to 0.23)	1994-2000	-0.28^*(-0.43 to -0.15)
	3	2000-2005	0.20^*(0.02 to 0.40)	2005-2010	-5.18^*(-5.40 to -4.97)	2000-2005	0.43^*(0.24 to 0.64)
	4	2005-2010	-4.54^*(-4.73 to -4.37)	2010-2023	-0.70^*(-0.74 to -0.67)	2005-2010	-3.98^*(-4.17 to -3.79)
	5	2010-2023	-0.69^*(-0.72 to -0.66)			2010-2023	-0.69^*(-0.73 to -0.66)
Age-standardized mortality rate	1	1990-1998	-4.29^*(-4.52 to -4.08)	1990-1998	-4.00^*(-4.63 to -3.38)	1990-1998	-4.19^*(-5.18 to -3.20)
	2	1998-2004	0.30 (-0.05 to 0.66)	1998-2004	0.26 (-0.70 to 1.25)	1998-2005	-0.72 (-1.86 to 0.42)
	3	2004-2008	-7.44^*(-7.97 to -6.92)	2004-2013	-5.81^*(-6.16 to -5.48)	2005-2008	-10.34^*(-14.72 to -5.74)
	4	2008-2013	-5.75^*(-6.06 to -5.44)	2013-2021	-1.81^*(-2.26 to -1.37)	2008-2013	-5.82^*(-7.12 to -4.51)
	5	2013-2017	-1.03^*(-1.66 to -0.41)	2021-2023	-9.09^*(-12.64 to -5.40)	2013-2017	-0.44 (-2.74 to 1.90)
	6	2017-2021	-3.34^*(-4.02 to -2.66)			2017-2023	-5.04^*(-5.87 to -4.21)
	7	2021-2023	-7.97^*(-9.35 to -6.57)
Age-standardized DALY rate	1	1990-1998	-3.13^*(-3.44 to -2.84)	1990-1998	-3.40^*(-3.64 to -3.16)	1990-1998	-2.94^*(-3.14 to -2.74)
	2	1998-2005	-0.86^*(-1.27 to -0.46)	1998-2004	-0.44^*(-0.85 to -0.03)	1998-2005	-0.84^*(-1.08 to -0.60)
	3	2005-2009	-6.68^*(-7.61 to -5.75)	2004-2012	-5.42^*(-5.61 to -5.25)	2005-2009	-6.80^*(-7.41 to -6.20)
	4	2009-2012	-4.24^*(-6.15 to -2.30)	2012-2021	-1.96^*(-2.13 to -1.80)	2009-2012	-4.01^*(-5.36 to -2.65)
	5	2012-2023	-2.22^*(-2.38 to -2.07)	2021-2023	-4.35^*(-5.88 to -2.80)	2012-2023	-2.18^*(-2.29 to -2.08)

表2

图2

图3

图4

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