1990—2021年吸烟相关结核病全球疾病负担研究

doi:10.19982/j.issn.1000-6621.20250519

中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (9): 1315-1323.doi: 10.19982/j.issn.1000-6621.20250519

1990—2021年吸烟相关结核病全球疾病负担研究

薛允莲¹, 李思婕², 江雪³, 刘贵浩⁴, 吴惠忠⁵, 汪婷婷³, 周湛淇³, 纪链容¹^,⁶, 王嘉雯⁷, 吴星华⁸, 吴粤⁹(), 周琳¹⁰()

¹ 南方医科大学附属广东省人民医院(广东省医学科学院)医疗保险事务处, 广州 510080
² 中山大学公共卫生学院流行病学系, 广州 510080
³ 南方医科大学附属广东省人民医院(广东省医学科学院)党办, 广州 510080
⁴ 南方医科大学附属广东省人民医院(广东省医学科学院)科研处, 广州 510080
⁵ 广东省公共卫生医学中心质量控制部, 广州 510630
⁶ 南方医科大学卫生管理学院, 广州 510515
⁷ 广东省公共卫生医学中心党委办公室(人力资源部), 广州 510630
⁸ 广东医科大学公共卫生学院, 东莞 523000
⁹ 广东省公共卫生医学中心办公室, 广州 510630
¹⁰ 南方医科大学附属广东省人民医院(广东省医学科学院)院长办公室, 广州 510080

收稿日期:2025-12-29 出版日期:2026-09-10 发布日期:2026-09-08
通信作者: 吴粤,周琳 E-mail:drwuyue@126.com;zhoulin_z@foxmail.com
基金资助:
广东省科技计划项目(2020B1111170014);广东省自然科学基金(2025A1515012867)

Global, regional, and national burdens of tuberculosis attributable to smoking from 1990 to 2021

Xue Yunlian¹, Li Sijie², Jiang Xue³, Liu Guihao⁴, Wu Huizhong⁵, Wang Tingting³, Zhou Zhanqi³, Ji Lianrong¹^,⁶, Wang Jiawen⁷, Wu Xinghua⁸, Wu Yue⁹(), Zhou Lin¹⁰()

¹ Department of Medical Insurance Affairs, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
² Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
³ Party Committee Office, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
⁴ Department of Scientific Research, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
⁵ Department of Quality Control, Guangdong Provincial Center for Public Health Medicine, Guangzhou 510630, China
⁶ School of Health Management, Southern Medical University, Guangzhou 510515, China
⁷ Party Committee Office (Human Resources Department), Guangdong Provincial Center for Public Health Medicine, Guangzhou 510630, China
⁸ School of Public Health, Guangdong Medical University, Dongguan 523000, China
⁹ Center Office, Guangdong Provincial Center for Public Health Medicine, Guangzhou 510630, China
¹⁰ Dean’s Office, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China

Received:2025-12-29 Online:2026-09-10 Published:2026-09-08
Contact: Wu Yue,Zhou Lin E-mail:drwuyue@126.com;zhoulin_z@foxmail.com
Supported by:
Science and Technology Program of Guangdong Province(2020B1111170014);Guangdong Basic and Applied Basic Research Foundation(2025A1515012867)

摘要/Abstract

摘要：

目的: 全面评估1990—2021年吸烟相关结核病全球疾病负担,并探讨潜在改进空间。 方法: 基于全球疾病负担(global burden of disease,GBD)2021数据库,分析吸烟归因结核病的死亡率和伤残调整寿命年(disability-adjusted life years,DALYs),并按年龄、性别及经济发展水平进行分层。采用分解分析识别负担变化的主要驱动因素,利用前沿分析展示在不同发展水平下潜在可实现的负担降低空间。 结果: 1990—2021年间,全球吸烟归因结核病年龄标化死亡率由14.17/10万下降至3.84/10万,年龄标化DALY率由483.39/10万下降至136.43/10万,年均百分比变化(EAPC)分别为-4.33%和-4.21%。30~89岁各年龄组吸烟归因结核病负担均呈下降趋势,死亡率降幅最大为65~69岁组,EAPC=-4.57%;DALY率降幅最大为60~64岁组,EAPC=-4.48%。204个国家和地区中,吸烟归因结核病负担总体以下降为主,其中,年龄标化DALY率仅莱索托和津巴布韦呈上升趋势,其余202个国家和地区均呈下降趋势。2021年低社会人口学指数(SDI)地区年龄标化死亡率和年龄标化DALY率分别为9.80/10万和320.81/10万,高于高SDI地区的0.21/10万和7.08/10万,提示SDI与吸烟归因结核病负担总体呈负向关系。分解分析显示,全球死亡数和DALYs下降主要由流行病学变化驱动,其对死亡数和DALYs变化的贡献率分别为250.49%和239.43%。前沿分析显示,不同国家和地区在相同SDI水平下的吸烟归因结核病负担仍存在明显差距,其中莱索托、基里巴斯和津巴布韦的年龄标化DALY率效率差值均较大,分别为3428.92、2018.03和1425.11。 结论: 1990—2021年全球吸烟归因的结核病负担呈明显下降趋势,但地区差异依然存在,尤其是低SDI地区负担更重。需进一步强化主动且针对性更强的控烟措施,以减少吸烟相关结核病负担。

关键词: 结核, 吸烟, 疾病负担, 流行病学研究

Abstract:

Objective: To comprehensively assess the smoking-related tuberculosis burden from 1990 to 2021 and explore potential improvement room. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed mortality and disability-adjusted life years (DALYs) attributable to smoking-related tuberculosis, stratified by age, sex, and socio-economic development level. Decomposition analysis was applied to identify key drivers of burden changes, while frontier analysis was used to visualize the potential for burden reduction at various levels of development. Results: From 1990 to 2021, the global age-standardized mortality rate of tuberculosis attributable to smoking decreased from 14.17 per 100000 population to 3.84 per 100000 population, and the age-standardized DALYs decreased from 483.39 per 100000 population to 136.43 per 100000 population, with estimated annual percentage changes (EAPC) of -4.33% and -4.21%, respectively. The smoking-related tuberculosis burden declined across all examined age groups aged 30-89 years, with the largest decrease in the mortality rate observed in the 65-69 year age group (EAPC: -4.57%) and the largest decrease in the DALY rate observed in the 60-64 year age group (EAPC: -4.48%). Among 204 countries and territories, the smoking-related tuberculosis burden generally showed a downward trend; only Lesotho and Zimbabwe showed increasing trends in age-standardized disability-adjusted life years rate (ASDR), whereas the remaining 202 countries and territories showed decreasing trends. In 2021, the age-standardized mortality rate (ASMR) and ASDR in low-socio-demographic index (SDI) regions were 9.80 per 100000 population and 320.81 per 100000 population, respectively, higher than those in high-SDI regions, which were 0.21 per 100000 population and 7.08 per 100000 population, suggesting an overall negative association between SDI and the smoking-related tuberculosis burden. Decomposition analysis showed that the declines in global deaths and DALYs were mainly driven by epidemiological changes, with contribution rates of 250.49% and 239.43%, respectively. Frontier analysis indicated that the smoking-related tuberculosis burden varied substantially across countries at the same SDI level; Lesotho, Kiribati, and Zimbabwe had relatively large ASDR effective differences of 3428.92, 2018.03, and 1425.11, respectively. Conclusion: The global burden of tuberculosis attributable to smoking showed a clear downward trend from 1990 to 2021, yet notable regional disparities persist, especially in low-SDI regions where the burden remains disproportionately high. Strengthening proactive and targeted tobacco control strategies is essential to further reduce smoking-related tuberculosis burden.

Key words: Tuberculosis, Smoking, Disease burden, Epidemiologic studies

中图分类号:

薛允莲, 李思婕, 江雪, 刘贵浩, 吴惠忠, 汪婷婷, 周湛淇, 纪链容, 王嘉雯, 吴星华, 吴粤, 周琳. 1990—2021年吸烟相关结核病全球疾病负担研究[J]. 中国防痨杂志, 2026, 48(9): 1315-1323. doi: 10.19982/j.issn.1000-6621.20250519

Xue Yunlian, Li Sijie, Jiang Xue, Liu Guihao, Wu Huizhong, Wang Tingting, Zhou Zhanqi, Ji Lianrong, Wang Jiawen, Wu Xinghua, Wu Yue, Zhou Lin. Global, regional, and national burdens of tuberculosis attributable to smoking from 1990 to 2021[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1315-1323. doi: 10.19982/j.issn.1000-6621.20250519

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1990—2021年吸烟相关结核病全球疾病负担研究

Global, regional, and national burdens of tuberculosis attributable to smoking from 1990 to 2021

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