诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (03): 219-256.doi: 10.16150/j.1671-2870.2024.03.001
王刚1(), 齐金蕾2, 刘馨雅3, 任汝静4, 林绍慧5, 胡以松6, 李海霞4, 谢心怡4, 王金涛4, 李建平4, 朱怡康5, 高梦伊5, 杨竣杰5, 王怡然5, 井玉荣3, 耿介立1, 支楠1, 曹雯炜1, 徐群1, 余小萍4, 朱圆4, 周滢7, 王琳7, 高超4, 李彬寅4, 陈生弟4, 袁芳8, 窦荣花9, 刘晓云10, 李雪娜11, 尹雅芙12, 常燕13, 徐刚14, 辛佳蔚15, 钟燕婷2, 李春波5(), 王颖3(), 周脉耕2(), 陈晓春15(), 代表中国阿尔茨海默病报告编写组
收稿日期:
2024-05-26
接受日期:
2024-06-23
出版日期:
2024-06-25
发布日期:
2024-06-25
通讯作者:
陈晓春 E-mail: chenxc998@163.com;基金资助:
WANG Gang1(), QI Jinlei2, LIU Xinya3, REN Rujing4, LIN Shaohui5, HU Yisong6, LI Haixia4, XIE Xinyi4, WANG Jintao4, LI Jianping4, ZHU Yikang5, GAO Mengyi5, YANG Junjie5, WANG Yiran5, JING Yurong3, GENG Jieli1, ZHI Nan1, CAO Wenwei1, XU Qun1, YU Xiaoping4, ZHU Yuan4, ZHOU Ying7, WANG Lin7, GAO Chao4, LI Binyin4, CHEN Shengdi4, YUAN Fang8, DOU Ronghua9, LIU Xiaoyun10, LI Xuena11, YIN Yafu12, CHANG Yan13, XU Gang14, XIN Jiawei15, ZHONG Yanting2, LI Chunbo5(), WANG Ying3(), ZHOU Maigeng2(), CHEN Xiaochun15(), representing the China Alzheimer's Disease Report Writing Group
Received:
2024-05-26
Accepted:
2024-06-23
Published:
2024-06-25
Online:
2024-06-25
摘要:
随着我国经济的持续增长和社会人口结构的显著变化,老龄化社会所带来的老年性疾病问题愈发受到关注,尤其是以阿尔茨海默病(Alzheimer’s disease,AD)为代表的神经退行性疾病,已成为严重影响老年人群健康和生活质量的重大挑战。近年来,中国的AD发病率、患病率和死亡率均呈现上升趋势,对患者家庭、社会乃至整个医疗保健系统构成了沉重的经济负担。为了积极应对这一挑战,响应国家“健康中国行动”的号召,推动医疗模式从疾病治疗向健康维护转变,由上海交通大学医学院附属仁济医院牵头,组织中国疾病预防控制中心慢性非传染性疾病预防控制中心、复旦大学公共卫生学院、上海市精神卫生中心、上海交通大学医学院附属瑞金医院、福建医科大学等多家权威机构的专家学者,共同编撰了《中国阿尔茨海默病报告2024》。该报告在2021、2022、2023年系列版本的基础上,进一步更新了中国AD的流行病学数据,深入分析了疾病经济负担的最新情况,并全面评估了我国AD诊疗服务的现状和公共卫生资源的配置。《中国阿尔茨海默病报告2024》的发布,不仅体现了我国在AD研究和防控方面的进步和努力,也彰显了全社会对老年健康问题的高度重视。本报告将为AD的预防、诊断和治疗提供科学的技术指导和有力的数据支持,为政府和相关部门制定针对性的卫生政策和干预措施提供专业依据,同时也为促进国内外在该领域的学术交流与合作搭建平台。期待通过这份报告的传播和应用,不仅能为专业人员提供参考和借鉴,也可以进一步提高公众对AD的认识,促进社会各界共同推动我国老年健康事业的发展,为实现“健康老龄化”而持续赋能。
中图分类号:
王刚, 齐金蕾, 刘馨雅, 任汝静, 林绍慧, 胡以松, 李海霞, 谢心怡, 王金涛, 李建平, 朱怡康, 高梦伊, 杨竣杰, 王怡然, 井玉荣, 耿介立, 支楠, 曹雯炜, 徐群, 余小萍, 朱圆, 周滢, 王琳, 高超, 李彬寅, 陈生弟, 袁芳, 窦荣花, 刘晓云, 李雪娜, 尹雅芙, 常燕, 徐刚, 辛佳蔚, 钟燕婷, 李春波, 王颖, 周脉耕, 陈晓春, 代表中国阿尔茨海默病报告编写组. 中国阿尔茨海默病报告2024[J]. 诊断学理论与实践, 2024, 23(03): 219-256.
WANG Gang, QI Jinlei, LIU Xinya, REN Rujing, LIN Shaohui, HU Yisong, LI Haixia, XIE Xinyi, WANG Jintao, LI Jianping, ZHU Yikang, GAO Mengyi, YANG Junjie, WANG Yiran, JING Yurong, GENG Jieli, ZHI Nan, CAO Wenwei, XU Qun, YU Xiaoping, ZHU Yuan, ZHOU Ying, WANG Lin, GAO Chao, LI Binyin, CHEN Shengdi, YUAN Fang, DOU Ronghua, LIU Xiaoyun, LI Xuena, YIN Yafu, CHANG Yan, XU Gang, XIN Jiawei, ZHONG Yanting, LI Chunbo, WANG Ying, ZHOU Maigeng, CHEN Xiaochun, representing the China Alzheimer's Disease Report Writing Group . China Alzheimer Report 2024[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(03): 219-256.
表2
我国各省、自治区及直辖市AD及其他痴呆的疾病负担数据(/10万)
地区 | 死亡率 | 标化 死亡率 | 患病率 | 标化 患病率 | 发病率 | 标化 发病率 | YLL率 | 标化 YLL率 | YLD率 | 标化 YLD率 | DALY率 | 标化 DALY率 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
安徽 | 38.0 | 30.0 | 1314.5 | 898.9 | 225.8 | 151.1 | 501.9 | 367.0 | 268.4 | 185.6 | 769.4 | 551.9 |
北京 | 35.1 | 29.5 | 1178.4 | 858.7 | 200.8 | 145.1 | 461.5 | 358.1 | 241.4 | 177.3 | 701.9 | 534.7 |
重庆 | 41.0 | 30.4 | 1445.5 | 905.0 | 250.6 | 153.4 | 552.1 | 372.7 | 292.6 | 185.4 | 843.6 | 557.3 |
福建 | 30.3 | 30.3 | 1062.0 | 933.7 | 179.3 | 155.2 | 398.4 | 370.3 | 216.5 | 191.8 | 614.3 | 561.5 |
甘肃 | 27.0 | 30.0 | 1092.2 | 911.9 | 192.2 | 154.4 | 394.2 | 370.7 | 220.5 | 188.2 | 613.9 | 558.2 |
广东 | 26.6 | 33.4 | 836.4 | 930.3 | 141.8 | 155.1 | 346.2 | 406.9 | 171.0 | 192.0 | 516.5 | 598.1 |
广西 | 33.9 | 29.5 | 1140.1 | 902.2 | 193.1 | 150.8 | 441.0 | 363.5 | 232.5 | 185.4 | 672.7 | 548.2 |
贵州 | 26.0 | 29.5 | 968.3 | 874.9 | 171.3 | 150.0 | 357.6 | 358.2 | 195.5 | 179.6 | 552.4 | 537.2 |
海南 | 31.6 | 29.5 | 1036.9 | 914.4 | 174.2 | 153.0 | 398.3 | 360.1 | 212.5 | 188.0 | 609.9 | 547.4 |
河北 | 37.7 | 38.1 | 1225.6 | 965.8 | 205.3 | 157.1 | 525.2 | 461.6 | 248.8 | 199.3 | 773.0 | 660.0 |
黑龙江 | 34.7 | 29.3 | 1307.9 | 874.4 | 229.6 | 149.4 | 488.0 | 358.3 | 265.9 | 180.6 | 752.7 | 538.1 |
河南 | 38.7 | 35.4 | 1244.8 | 975.6 | 207.3 | 158.0 | 517.0 | 432.6 | 254.9 | 202.0 | 770.8 | 633.7 |
香港 | 80.3 | 26.9 | 1997.1 | 819.1 | 326.4 | 137.5 | 886.3 | 332.9 | 422.0 | 169.9 | 1307.3 | 502.4 |
湖北 | 33.9 | 30.6 | 1249.8 | 900.6 | 217.1 | 152.4 | 470.9 | 374.3 | 254.1 | 186.0 | 724.0 | 559.4 |
湖南 | 36.7 | 29.8 | 1317.7 | 909.5 | 226.7 | 153.3 | 492.9 | 364.6 | 268.0 | 187.2 | 760.0 | 551.1 |
内蒙古 | 28.5 | 29.1 | 1123.9 | 885.4 | 196.8 | 150.5 | 406.2 | 355.8 | 228.1 | 183.0 | 633.5 | 538.2 |
江苏 | 43.4 | 30.9 | 1453.8 | 900.4 | 245.8 | 149.9 | 565.8 | 374.3 | 296.0 | 185.0 | 860.7 | 558.6 |
江西 | 25.4 | 26.2 | 901.0 | 769.1 | 162.5 | 137.0 | 348.6 | 321.9 | 183.5 | 158.8 | 531.5 | 480.2 |
吉林 | 38.0 | 34.9 | 1380.5 | 964.5 | 236.5 | 158.4 | 544.9 | 426.3 | 279.8 | 199.2 | 823.6 | 624.6 |
辽宁 | 39.6 | 29.4 | 1460.3 | 879.2 | 250.8 | 148.1 | 543.8 | 357.4 | 297.5 | 181.6 | 840.1 | 538.3 |
澳门 | 39.8 | 29.5 | 1218.1 | 944.7 | 197.0 | 154.7 | 484.4 | 364.5 | 253.1 | 195.4 | 736.7 | 559.3 |
宁夏 | 20.4 | 30.1 | 807.3 | 879.8 | 142.4 | 149.3 | 298.0 | 368.9 | 162.9 | 181.4 | 460.3 | 549.7 |
青海 | 19.4 | 30.6 | 785.9 | 923.9 | 140.6 | 157.9 | 285.0 | 378.1 | 158.7 | 191.1 | 443.1 | 568.5 |
陕西 | 29.8 | 29.9 | 1150.3 | 899.4 | 200.4 | 152.0 | 422.7 | 366.3 | 235.0 | 187.1 | 657.0 | 552.7 |
山东 | 38.1 | 30.0 | 1265.4 | 856.7 | 219.1 | 146.7 | 508.9 | 367.5 | 258.5 | 177.0 | 766.4 | 543.8 |
上海 | 43.8 | 28.3 | 1528.5 | 929.0 | 252.3 | 153.6 | 544.6 | 340.9 | 314.3 | 191.4 | 857.9 | 531.7 |
山西 | 27.1 | 27.5 | 997.3 | 796.2 | 176.8 | 138.9 | 377.4 | 334.1 | 202.4 | 164.4 | 578.9 | 497.8 |
四川 | 41.4 | 29.7 | 1477.6 | 913.0 | 255.1 | 154.3 | 554.3 | 365.5 | 299.9 | 187.5 | 853.3 | 552.3 |
天津 | 34.3 | 29.5 | 1253.4 | 888.7 | 214.7 | 149.7 | 466.0 | 359.3 | 255.2 | 183.2 | 720.3 | 541.8 |
西藏 | 10.3 | 23.8 | 503.4 | 910.2 | 90.8 | 155.7 | 157.9 | 304.7 | 101.5 | 188.1 | 259.1 | 492.1 |
新疆 | 17.3 | 28.4 | 663.4 | 853.0 | 118.8 | 147.0 | 248.3 | 352.5 | 133.5 | 175.4 | 381.1 | 526.9 |
云南 | 26.8 | 30.8 | 1010.0 | 943.3 | 175.6 | 158.8 | 370.9 | 378.2 | 204.0 | 193.5 | 574.1 | 570.9 |
浙江 | 38.6 | 33.3 | 1186.6 | 882.4 | 202.1 | 149.2 | 510.8 | 407.2 | 240.9 | 180.6 | 750.9 | 587.1 |
表8
体液和影像学生物标志物的预期用途*
用途 | CSF生物标志物 | 血浆生物标志物 | 影像学生物标志物 |
---|---|---|---|
诊断 | P-tau181/Aβ42, T-tau/Aβ42, Aβ42/Aβ40 | P-tau 217,P-tau217/np-tau 217 | 淀粉样蛋白-PET |
治疗效果评价 | P-tau181/Aβ42, T-tau/Aβ42, Aβ42/Aβ40,pT205, MTBR-243, 非磷酸化Tau片段,NfL,GFAP | P-tau 217,P-tau217/np-tau 217,pT205,Nfl,GFAP | Aβ-PET, Tau-PET,MRI解剖,FDP-PET |
并经病理学鉴定 | Nfl,αSyn-SAA | 解剖MRI,FDP-PET,脑梗死,白质高信号,血管周围间隙扩大 |
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