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广州医药杂志服务号
论著

全球、地区及国家非酒精性脂肪性肝病负担的三十年演变:基于年龄-时期-队列分析

The three-decade evolution of the global,regional,and national burden of nonalcoholic fatty liver disease:an age-period-cohort analysis

:563-574
 
       目的 评估过去30年,204个国家和地区非酒精性脂肪性肝病(NAFLD)伤残调整生命年(DALYs)的变化趋势,以及年龄-时期-队列效应。方法 所有数据来源于全球疾病负担研究(GBD)数据。针对1990—2019年204个国家和地区NAFLD的DALYs趋势进行分析,采用折点回归模型评估年龄标化DALYs率年均百分比变化(APC);同时,利用年龄-时期-队列模型评估年龄、时期及出生队列对NAFLD的DALYs的影响。结果 1990—2019年,NAFLD的DALYs总量增加了62.92%,全人群DALYs率(每10万人)也增加了12.65%,而年龄标化DALYs率则由1990年的63.28(95%UI:48.58,80.86)下降至2019年的53.33(95%UI:40.73,68.29),降幅约为15.72%。全球范围内,APC模型估算的DALYs净漂移为每年-0.88%(95%CI:-0.91~ -0.85)。无论是DALYs总量、全人群DALYs率还是年龄标化DALYs率,其在女性和男性中的变化趋势与总体趋势一致。尽管全球及按社会人口学指数(SDI)分组的5个区域中,≥80岁人群的DALYs时间趋势逐步上升,但仅高SDI区域的上升趋势较为明显。折点回归分析显示,1990—2019年,年龄标化DALYs率呈现“先缓慢上升、后下降、再上升、最终下降”的波动趋势,总体为下降趋势,1990—2019年平均APC为-0.58%。年龄-时期-队列模型表明,全球、各区域及国家均存在不利的年龄效应,而时期效应与出生队列效应在不同区域总体呈有利趋势,但也存在一定差异。结论 1990—2019年,全球NAFLD的DALYs总量和全人群DALYs率上升,而年龄标化DALYs率总体下降,高SDI地区老年人负担上升更明显。年龄-时期-队列分析显示全球普遍存在不利的年龄效应,时期和出生队列效应总体有利但区域差异显著。

      Objective To evaluate the trends in the disability-adjusted life years(DALYs)of nonalcoholic fatty liver disease(NAFLD)and the effects of age-period-cohort in 204 countries and regions in the past 30 years.Methods All data were obtained from the Global Burden of Disease Study 2019.Trends in DALYS for NAFLD were assessed in 204 countries and territories from 1990 to 2019,and trends in the annual percentage change(APC)of age-standardized DALY rate were assessed by a joinpoint regression model.And age-period-cohort models were used to assess the effects of age-period-cohort on DALYs for NAFLD.Results From 1990 to 2019,the number of DALYs due to NAFLD increased by 62.92%,and all-age DALY rate per 100,000 population also increased by 12.65%,while the age-standardized DALY rate decreased from 63.28(48.58,80.86)in 1990 to 53.33(40.73,68.29)in 2019,a decrease of about 15.72%.Globally,the APC model estimated a net drift for DALYs of -0.88%(95%CI:-0.91,-0.85)per year,and for the number of DALYs,all-age DALYs rate,age-standardized DALY rate and net drift in female and male,the change trend of all regions over the past 30 years were consistent with the total population.Although the time trend of NAFLD DALYs among people over 80 years old was gradually rising in the world and five regions grouped according to socio‐demographic index(SDI),only the high SDI region had a more obvious time trend.Globally,the joinpoint regression analysis showed the age-standardized DALY rate appeared a trend of first gradually upward and then downward and then upward and finally downward during 1990-2019.Overall there was a downward trend,with an average APC of -0.58 during 1990 to 2019.Age-period-cohort model showed that unfavourable age effects were found in the world,all regions and countries,while the period and birth cohorts effects in different regions were favorable,but there were also some differences.Conclusions From 1990 to 2019,the global DALYs and all-age DALY rates of NAFLD increased,whereas the age-standardized DALY rate showed an overall decline,with a more pronounced burden among older adults in high-SDI regions.The age-period-cohort analysis revealed unfavorable age effects worldwide,while period and birth cohort effects were generally favorable but varied considerably across regions.
专题:体重管理

年龄调整内脏脂肪指数与骨关节炎患病率之间的关联:一项横断面研究

Association between the age-adjusted visceral adiposity index and osteoarthritis prevalence:A crosssectional study

:679-687
 
        目的 评估年龄调整内脏脂肪指数(AVAI)与骨关节炎患病率之间的关联。方法 采用加权多元Logistic回归模型和平滑曲线拟合分析AVAI和骨关节炎患病率之间的关系,通过亚组分析和交互作用检验探讨这一关系在不同亚组人群之间的效应差异。此外,通过受试者工作特征曲线(ROC)分析评估AVAI对骨关节炎的预测效能。结果 本研究基于美国国家健康与营养调查(NHANES)2011—2018年数据,共纳入5 929例参与者。较高的AVAI指数与骨关节炎患病率呈正相关(OR=1.22,95%CI:1.07~1.40)。随着AVAI指数的增加,骨关节炎患病风险呈现先上升后缓慢下降的趋势,AVAI的拐点为-4.48。在性别、年龄、教育程度和婚姻状况亚组中观察到交互作用。结论 AVAI与骨关节炎患病率之间存在非线性关系,当AVAI低于-4.48时,骨关节炎的患病风险增加。AVAI可作为一种有效、便捷的筛查工具,用于早期识别骨关节炎高风险人群。

    Objective This study aimed to evaluate the association between the age-adjusted visceral adiposity index(AVAI)and the prevalence of osteoarthritis(OA).Methods Survey-weighted multivariable logistic regression models and smooth curve fitting were used to examine the relationship between AVAI and OA prevalence.Subgroup analyses and interaction tests were conducted to explore potential effect modifications across different population subgroups.Additionally,the predictive capability of AVAI for osteoarthritis was assessed using receiver operating characteristic(ROC)curve analysis. Results A total of 5 929 participants from the National Health and Nutrition Examination Survey(NHANES)2011–2018 were included.Higher AVAI levels were significantly associated with an increased prevalence of OA(OR=1.22;95%CI:1.07–1.40).As AVAI increased,the risk of OA initially rose and then gradually declined,with an inflection point observed at ?4.48.Significant interactions were found across subgroups stratified by sex,age,education level,and marital status.Conclusions There exists a nonlinear relationship between AVAI and OA prevalence,with a significant increase in osteoarthritis risk observed when AVAI falls below -4.48.AVAI serves as an effective and convenient screening tool for identifying individuals at high risk of OA at an early stage.
论著

不同年龄段皮罗序列征患儿动脉血气分析的特点、机械通气及住院时间比较

Characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in children with Pirre Robin sequence at different ages

:30-33
 
目的 探讨不同年龄段皮罗序列征患儿血气分析的特点、手术后机械通气时间和住院时间。方法 收集新生儿及非新生儿III度皮罗序列征(PRS)患儿各30例,PRS患儿入院后通过桡动脉进行采集血标本进行血气分析,比较2组血标本的 pH 值、PCO2 、PO2 、HCO-3、BE、乳酸、AG、A-aDO2的特点、手术后机械通气时间及住院时间。结果 新生儿组PCO2、HCO-3、BE、乳酸及A-aDO2高于非新生儿组,非新生儿组PO2及AG高于新生儿组。2组pH值、PO2、AG均在正常范围,机械通气及住院时间与乳酸呈正相关,与年龄呈负相关。结论 不同的年龄阶段,PRS患儿的动脉血气分析的结果不同,高乳酸与低年龄PRS患儿手术后机械通气时间及住院时间长。
Objective To investigate the characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in different age patients with Pirre Robin sequence (PRS). Methods Sixty children with III-grade PRS were divided into two groups according to their age, as neonate group and non-neonate group. The blood samples were collected from radial artery after admission for blood gas analysis, the characteristics of pH value, partial pressure of carbon dioxide (PCO2), partial pressure of blood oxygen (PO2), bicarbonate ion (HCO-3), base excess (BE), lactic acid (Lac), anion gap (AG) , alveolar artery oxygen pressure difference (A-aDO2) , postoperative mechanical ventilation time and hospital stay were compared between the two groups. Results The levels of PCO2, HCO-3, BE, Lac and A-aDO2 in neonate group were higher than those in non-neonate group, and the levels of PO2 and AG in non-neonate group were higher than those in neonate group. The pH value, PO2 and AG of the two groups were in the normal range. Post-operative mechanical ventilation time and hospital stay were positively correlated with Lac and negatively correlated with age. Conclusions In different age groups, the results of arterial blood gas analysis in PRS children were different, and the time of mechanical ventilation and hospital stay were longer in higher Lac level and younger patients with PRS.
论著

广州市白云区男性年龄因素与精液质量现况研究

Study on male age and semen quality in Baiyun District of Guangzhou

:83-86
 
目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例(占比57.52%),随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低(P<0.05)。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好(P<0.05),是男性生育的黄金年龄。
Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects.Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases(57.52%)of male semen data of childbearing age in Baiyun District were within the normal range.With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually(P < 0.05). Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups(P < 0.05),which is the golden age of male fertility.
论著

不同年龄段患者椎间孔镜下腰椎间盘突出症疗效分析

Analysis of curative effect of lumbar disc herniation under transforaminal endoscopy in patients of different ages

:73-76
 
目的 观察椎间孔镜下腰椎间盘突出症的近期疗效,分析不同年龄段对手术疗效的影响。方法 收集120例腰椎间盘突出患者,分成A、B、C三个研究小组:A青年组(年龄≤44岁)、B中年组(44岁<年龄<65岁)、C老年组(年龄≥65岁)。以术前、术后1天、术后3月、术后6月为界限,分析患者的疼痛视觉模拟量表(VAS)评分,并计算相对应的腰椎Oswestry功能障碍指数;术后1年用改良Macnab标准评价疗效优良率。结果 针对不同试验小组的VAS评分、ODI指数等进行对比分析:术后1天的对比差异不存在统计学意义(P>0.05);术后3个月、6个月比较差异有统计学意义(P<0.05),其中C组术后3月、6月VAS评分、ODI指数高于A、B组,差异有统计学意义(均P<0.05),A、B组间比较无统计学差异(P>0.05)。术后1年三组间疗效优良率比较无统计学差异(P>0.05)。结论 不同年龄段患者椎间孔镜的近期疗效显著,中青年患者恢复快,中期疗效好。
Objective To observe the short-term curative effect of transforaminal endoscopy for lumbar disc herniation, and to analyze the influence of different age on the curative effect. Methods 120 patients with lumbar disc herniation were collected, the study was divided into three groups: group A, group B and group C: group A (young adults, 44 years or older), group B (44 years or older) and group C (65 years or older). The visual analogue scale (Vas) scores of the patients were analyzed and the corresponding Oswestry index of the lumbar spine was calculated according to the preoperative, 1 day, 3 months and 6 months postoperatively. A modified Macnab was used to evaluate the rate of excellency and good results 1 year after operation. Results The Vas score and Odi index of different groups were compared. There was no statistically difference at 1 day after operation (P > 0.05). After 3 months and 6 months, there was statistically difference (P<0.05), among them, the VAS scores and Odi index of group C were higher than those of group B, the difference was statistically significant (P<0.05), there was no statistically difference between group A and group B (P > 0.05). There was no statistically difference between the three groups in the first year after operation (P > 0.05). Comparison of VAS score and ODI index among the three groups: there was no statistically difference at 1 day after operation (P>0.05); there was statistically difference at 3 months and 6 months after operation (P<0.05), among which VAS score and ODI index of group C were higher than those of group A and group B (all P<0.05), but there was no statistically difference between group A and group B (P>0.05). There was no statistically difference in the excellent and good rate among the three groups one year after operation (P>0.05). Conclusion The short-term curative effect of intervertebral foramina in patients of different ages is remarkable, the young and middle-aged patients recover quickly, and the medium-term curative effect is good.
论著

探讨不同年龄儿童性早熟影响因素及预防措施

Influencing factors and preventive measures of precocious puberty in children of different ages

:10-13
 
目的 探讨不同年龄儿童性早熟的影响因素及预防措施。方法 本文将2020年1月—2021年1月的性早熟儿童45例(观察组)与正常健康儿童45例(对照组)作为研究对象,通过问卷调查的形式了解所选儿童的家庭因素、饮食、生活方式与社会因素等方面的情况,通过单因素分析与多因素分析探讨相关影响因素。结果 观察组不同年龄段儿童在骨龄、身高、体质量、BMI方面存在统计学差异,P<0.05;观察组性激素水平明显高于对照组,P<0.05。结论 儿童性早熟的发生与生活习惯、家庭关系、饮食习惯、母亲初潮年龄等因素有关,帮助其养成科学合理的生活习惯与饮食习惯,改善家庭关系可很好的降低并预防儿童性早熟的发生。对于已经出现性早熟现象的儿童来说,学校与家庭要及时给予其合理的健康教育,包括心理方面与生殖健康方面,及时有效的疏导可有效避免性早熟对儿童心理方面造成不良影响。
Objective To explore the influencing factors and preventive measures of precocious puberty in children of different ages. Methods 45 cases of precocious puberty children (observation group) and 45 cases of normal healthy children (control group) from January 2020 to January 2021 were selected as the research objects. The family factors, diets, lifestyles and social factors of the selected children were investigated by questionnaire survey, and the related influencing factors were discussed by single factor analysis and multi factor analysis. Results There were statistical differences in bone age, height, weight and BMI among children of different ages in the observation group, P<0.05. The levels of sex hormones in the observation group were higher than those in the control group, P<0.05. Conclusion The occurrence of children's precocious puberty is related to living habits, family relations, eating habits, mother's menarche ages and other factors. To help them develop scientific and reasonable living habits and dietary habits and improve family relations can reduce and prevent the occurrence of children's precocious puberty. For children with precocious puberty, schools and families should give them proper health education in time, including psychological and reproductive health. Timely and effective counseling can effectively avoid the adverse effects of precocious puberty on children's psychology.
临床诊疗

年龄与性别对鼻咽癌患者自我病情延误的影响

Age and gender affect self-delay of nasopharyngeal carcinoma patients

:88-90
 
目的 以临床病例为研究对象,探讨年龄与性别对鼻咽癌自我病情延误的影响,寻找鼻咽癌科普宣教的重点靶标人群。方法 收集2015年4月—2015年12月广州医科大学附属肿瘤医院放疗科鼻咽癌病区收治的经活检病理确诊初治鼻咽癌患者62例(年龄28~77岁,中位年龄49岁),记录患者主诉症征出现至病理确诊鼻咽癌其相关症状的持续时间,采用t检验和Pearson相关分析探讨性别及年龄对鼻咽癌确诊前相关症征持续时间的影响。结果 62例患者确诊前均自我发现鼻咽癌相关症征,其中43例(69.4%)发现鼻咽原发灶相关症状,35例(56.5%)发现颈部淋巴肿大症状。Pearson相关分析显示,鼻咽癌确诊前颈部淋巴结肿大持续时间与年龄呈正相关(P<0.05);t检验结果显示,男性患者鼻咽癌确诊前症状持续时间大于女性患者(P<0.05)。结论 年龄较大和男性人群鼻咽癌自我病情延误较为严重,应该作为包括临床症状在内的鼻咽癌科普宣教的重点人群。
临床诊疗

幽门螺杆菌感染与年龄及血脂异常的相关性

Correlative Study between Helicobacter pylori infection , Age and dyslipidemia

:75-77
 
目的 探讨幽门螺杆菌(HP)感染与不同年龄段健康体检人群中血脂异常发病率的相关性。方法 在健康体检人群中开展13C尿素呼气试验及血脂等检测,对比不同年龄段人群中HP感染率,研究HP感染与年龄及血脂异常的相关性。结果 不同年龄段人群之间的HP感染率无差异。HP阳性组的血脂异常患病率在30岁后的每个年龄段内均高于HP阴性人群,在60~69岁阶段两组人群差异最明显,血脂异常的发生率分别为74.29%vs 26.15%。结论 HP的感染与血脂异常相关,HP阳性组人群血脂异常患病率随年龄增高而增高的趋势较HP阴性组更加明显。
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