2021年全球疾病负担（Global Burden of Disease, GBD）研究报告（以下简称GBD 2021）通过对100 983个数据源中371种疾病和伤害的负担进行了全面分析，估算了伤残损失年、寿命损失年、伤残调整生命年和健康期望寿命。1990年至2019年间，全球全因死亡率年变化率的范围为-0.9%~2.4%，而2020年和2021年因新型冠状病毒肺炎（corona virus disease 2019， COVID-19）导致的死亡人数分别增加了10.8%和7.5%。2021年，COVID-19成为全球第二大死因，每10万人中有94.0例死亡，其他主要死因如缺血性心脏病和脑卒中的死亡率分别为每10万人中有108.7例和87.4例。全球期望寿命从1990年的65.5岁增加到2019年的73.3岁，但在2021年因COVID-19影响下，又降至71.7岁，COVID-19使全球期望寿命减少了2.2年，显著影响了全球健康改善的长期趋势。2021年GBD数据显示，1990年至2021年间，中国的期望寿命显著增加，女性从69.9岁增加到80.7岁，男性从65.7岁增加到74.9岁。2021年，中国死亡人数顺位前10位分别为，脑卒中2 591 647人；缺血性心脏病1 956 859人；慢性阻塞性肺疾病1 285 433人；气管、支气管和肺癌为814 364人；阿尔茨海默病及其他痴呆为491 774人；胃癌为445 013人；高血压性心脏病为328 119人；食管癌为296 443人；结肠和直肠癌为275 129人；道路伤害为242 320人。且这些疾病的发病率和死亡率持续上升。烟草、高血压和饮食风险是中国主要的健康风险因素。通过对GBD 2021数据的系统整理和分析，我国应加强慢性病管理，提高公共卫生应急能力，关注健康不平等问题，并推动基础研究和国际合作，以提升人民整体健康水平。

The Global Burden of Disease Study 2021 (GBD 2021) analyzed 371 diseases and injuries using 100,983 data sources, estimating years lived with disability, years of life lost, disability-adjusted life years, and healthy life expectancy. From 1990 to 2019, the annual rate of change in global all-cause mortality ranged from -0.9% to 2.4%, while deaths increased by 10.8% and 7.5% in 2020 and 2021 respectively due to COVID-19. In 2021, COVID-19 was the second lea-ding cause of death globally, with a mortality rate of 94.0 per 100 000. The mortality rates of other major causes, such as ischemic heart disease and stroke were 108.7 and 87.4 per 100 000, respectively. Global life expectancy rose from 65.5 years in 1990 to 73.3 years in 2019 but dropped to 71.7 years in 2021 due to COVID-19, which reduced life expectancy by 2.2 years, significantly impacting the trend of health improvement. In China, GBD 2021 data shows a significant increase in life expectancy from 1990 to 2021: from 69.9 to 80.7 years for women and from 65.7 to 74.9 years for men. However, non-communicable diseases such as cardiovascular diseases, cancers, and chronic respiratory diseases remain major health threats. In 2021, these diseases had the highest burden among the top ten causes in China, with rising incidence and morta-lity rates. Major health risk factors in China include tobacco, hypertension, and dietary risks. This paper, through the systematic analysis of GBD 2021 data, reveals current trends in disease burden globally and in China, and proposes public health strategy recommendations. China should enhance chronic disease management, improve public health emergency responses, address health inequalities, and promote basic research and international cooperation to improve overall health levels.