Published
2026-02-03
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Articles
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出生窒息和产伤所致新生儿脑病的全球与区域疾病负担（1990-2021 年）及至 2036 年的预测
姜 若轩
安徽医科大学第二附属医院儿科
尹 双
安徽医科大学第二附属医院儿科
洪 宝钰
安徽医科大学第二附属医院儿科
蔡 浩
安徽医科大学附属阜阳医院儿科
程 雁
安徽医科大学第二附属医院儿科
DOI: https://doi.org/10.59429/xjjz.v7i4.12782
Keywords: 新生儿脑病；发病率；死亡率；伤残调整寿命年；社会人口学指数；joinpoint 回归分析
Abstract
背景：出生窒息和产伤所致新生儿脑病的全球、区域及国家层面的疾病负担及其趋势的最新估计，对于制定 循证医学策略、实施预防措施及合理配置医疗资源至关重要。本研究旨在评估 1990 年至 2021 年间相关疾病负担的 变化，并预测其至 2036 年的发展趋势。方法 本研究利用《全球疾病负担研究 2021》（GBD 2021）数据库的数据， 分析由出生窒息与产伤导致的新生儿脑病的疾病负担趋势。主要结局指标包括 1990 年至 2021 年的年龄标化发病率 （ASIR）、年龄标化死亡率（ASMR）及伤残调整寿命年（DALYs）。研究在全球、区域及国家层面进行评估，并采 用折点回归分析和健康不平等斜率指数来探讨其时序变化特征。此外，采用自回归整合滑动平均模型（ARIMA）预 测至 2036 年的疾病负担。均方根误差（RMSE）、平均绝对误差（MAE）及平均绝对百分比误差（MAPE）用于评 价模型预测的准确性。结果：全球范围内，新生儿脑病的 ASIR、ASMR 及 DALYs 总体呈下降趋势。但在中部撒哈 拉以南非洲、东部撒哈拉以南非洲、西部撒哈拉以南非洲和大洋洲四个地区，其绝对发病数、死亡数及 DALYs 总 量仍呈上升趋势。尽管如此，这些地区的标化率指标（ASIR、ASMR、DALYs 率）仍持续下降。研究发现，男性患 儿的疾病负担显著高于女性，且疾病负担主要集中于经济极度不发达地区。预测结果显示，2021 年以后全球 ASIR、 ASMR 及 DALYs 率将继续下降。结论：新生儿脑病的全球疾病负担总体呈下降趋势。尽管健康不平等程度有所改 善，但疾病负担仍主要集中于经济欠发达地区。同时，男性承担的疾病负担更高，提示需要采取性别特异性干预措 施。要有效降低相关挑战，亟需在资源有限地区和易感人群中实施更具针对性的政策与综合预防策略。
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