多发性硬化症(MS)是导致年轻人残疾的主要原因,并造成相当大的社会和经济负担。中国在全国范围内缺乏MS发病率数据。我们进行了首次全国性的基于医院的研究,以评估中国MS的发病率和住院负担。
■本研究基于国家医院质量监控系统的管理数据库,覆盖中国大陆所有1665家三级医院。所有患者的“病历主页”,包括346个变量,包括人口特征,诊断,程序,和费用等。,通过标准方案在每个三级医院中统一收集。MS由2010年国际小组MS标准定义,并由ICD-10代码(G35•0)识别。
■从2016年到2018年,我们确定了27,336名住院的15,060名MS患者;在这些患者中,新诊断出9,879人。每100,000人年的年龄和性别调整发生率为0•235(95%置信区间[CI]0•230-0•240),儿童为0•055(0•050-0•060),成人为0•288(0•282-0•294),分别。女性与男性的比例为2·02;疾病发作的高峰年龄为40-49岁。高纬度和高海拔地区的居民更容易患MS(F=8•99;p<0•001)。常见的合并症包括高血压(18•8%),糖尿病(7•2%),中风(14•7%),抑郁或焦虑(3•7%),和自身免疫性疾病(2•3%)。截至2016-2018年,104名成人和2名儿童死亡。医院死亡率为每千人年9•9。
■第一次,我们获得了中国儿童中MS的全国发病率为0.055例,成人中MS的发病率为0.288例.MS发病率的地理分布呈现南北纬度梯度和东西高度梯度。
■国家科学基金(81801199,91642205,81830038);人脑保护先进创新中心,首都医科大学,北京。
BACKGROUND: Multiple sclerosis (MS) is a leading cause of disability among young adults and effects considerable social and economic burdens. Data of MS incidence in
China at the national level is lacking. We conducted the first nationwide hospital-based study to estimate the incidence and hospitalization burden of MS in
China.
METHODS: This study is based on an administrative database of the National Hospital Quality Monitoring System, which covers all 1665 tertiary hospitals in mainland
China. The \"Medical Record Homepage\" of all patients, including 346 variables including demographic characteristics, diagnoses, procedures, and expenses etc., were uniformly collected across each tertiary hospital via standard protocol. MS was defined by the 2010 International Panel criteria for MS and was identified by ICD-10 code (G35•0).
RESULTS: We identified 27,336 hospital admissions for 15,060 MS patients from 2016 to 2018; amongst these patients, 9,879 were newly diagnosed. The age- and sex-adjusted incidence per 100,000 person-years is 0•235 (95% confidence interval [CI] 0•230-0•240), with 0•055 (0•050-0•060) in children and 0•288 (0•282-0•294) in adults, respectively. The female to male ratio is 2•02; the peak disease onset is age of 40-49 years. Residents in high-latitude and high-altitude areas are more likely to develop MS (F = 8•99; p < 0•001). Prevalent comorbidities include hypertension (18•8%), diabetes (7•2%), stroke (14•7%), depression or anxiety (3•7%), and autoimmune disease (2•3%). Through 2016-2018, 104 adults and 2 children died, with a hospital mortality rate of 9•9 per 1,000 person-years.
CONCLUSIONS: For the first time, we obtain the national incidence of MS as 0.055 in children and 0.288 in adults per 100,000 in
China. The geographical distribution of MS incidence presented a north-south latitude gradient and a west-east altitude gradient.
BACKGROUND: National Science Foundation of
China (81801199, 91642205, and 81830038); Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing.