1990—2023年中国儿童和青少年泌尿系统疾病负担研究

doi:10.12372/jcp.2026.25e1478

临床儿科杂志 ›› 2026, Vol. 44 ›› Issue (6): 546-555.doi: 10.12372/jcp.2026.25e1478

1990—2023年中国儿童和青少年泌尿系统疾病负担研究

顾信佳¹, 郑智慧¹, 梅伶俐¹, 郑金鑫²^,³, 刘太祥¹, 诸纪华¹()

¹ 浙江大学医学院附属儿童医院儿童少年健康与疾病国家临床医学研究中心（浙江杭州 310052）
² 上海交通大学医学院中国热带病研究中心全球卫生学院（上海 200025）
³ 上海交通大学爱丁堡大学健康中心（上海 200240）

收稿日期:2025-11-24 修回日期:2026-01-22 录用日期:2026-04-21 出版日期:2026-06-15 发布日期:2026-06-04
通讯作者: 诸纪华 E-mail:jihuazhu@zju.edu.cn
作者简介:第一联系人：作者贡献（Authors’ Contributions）
顾信佳对研究的思路及设计有重要贡献，起草研究论文并对重要的知识内容进行批判性审查及修订；郑智慧、梅伶俐、郑金鑫和刘太祥为研究获取、分析及解释数据；诸纪华对将要发表的版本进行最终定稿，确保与论文任何部分的准确性及诚信有关的质疑得到恰当的调查和解决。

Burden of urinary system diseases in children and adolescents in China, 1990-2023

GU Xinjia¹, ZHENG Zhihui¹, MEI Lingli¹, ZHENG Jinxin²^,³, LIU Taixiang¹, ZHU Jihua¹()

¹ Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou 310052, Zhejiang, China
² School of Global Health, Chinese Centre for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
³ One Health Centre, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai 200240, China

Received:2025-11-24 Revised:2026-01-22 Accepted:2026-04-21 Published:2026-06-15 Online:2026-06-04
Contact: ZHU Jihua E-mail:jihuazhu@zju.edu.cn

摘要/Abstract

摘要：

目的分析1990—2023年中国20岁以下儿童和青少年六类主要泌尿系统疾病的疾病负担及其长期变化趋势，并量化人口学与流行病学因素的驱动作用。方法利用全球疾病负担（GBD）2023数据库，提取1990—2023年中国20岁以下人群的发病人数、发病率、伤残调整寿命年（DALYs）和DALY率等指标。采用描述性统计，基于Joinpoint回归模型估计平均年度变化百分比（average annual percentage change，AAPC）以分析非线性时间趋势，并应用人口学分解法量化人口年龄结构、人口规模和年龄别特定率对DALYs变化的贡献。结果 1990—2023年间，中国20岁以下人群泌尿系统疾病总发病率从384.70/10万降至285.38/10万，总DALY率从160.82/10万降至39.81/10万。疾病谱构成发生显著变化，尿路感染和间质性肾炎始终是发病率最高的病种（2023年占68.70%），而慢性肾脏病（48.61%）和肾癌（26.03%）是DALY负担最主要的来源。疾病分布呈现明显的年龄与性别差异。分解分析显示，除先天性泌尿生殖系统异常外，其余五种疾病DALYs下降主要归因于流行病学因素的改善（贡献率58.10%~83.94%）。结论 1990—2023年中国儿童青少年泌尿系统疾病负担显著下降，主要得益于公共卫生措施与临床诊疗进步。未来防控策略需关注疾病谱变迁，并针对重点人群（如青春期女性、青少年男性及婴幼儿）开展精准干预。

关键词: 泌尿系统疾病, 疾病负担, 时间趋势, 分解分析, 儿童及青少年

Abstract:

Objective To assess the disease burden and long-term trends of six major urinary system diseases among children and adolescents under 20 years in China from 1990 to 2023, and to quantify the driving effects of demographic and epidemiological factors. Methods Data on the number of incident cases, incidence rates, disability-adjusted life years (DALYs), and DALY rates for the Chinese population under 20 years old from 1990 to 2023 were extracted from the Global Burden of Disease Study (GBD) 2023. Descriptive statistics and the average annual percentage change (AAPC) derived from Joinpoint regression models were employed to analyze temporal trends. A demographic decomposition method was applied to quantify the contributions of changes in age structure, population size, and age-specific rates to the changes in DALYs. Results From 1990 to 2023, the overall incidence rate of urinary system diseases in China's population under 20 years declined from 384.70 to 285.38 per 100,000, and the overall DALY rate decreased from 160.82 to 39.81 per 100,000. Significant shifts were observed in the disease spectrum. Urinary tract infections and interstitial nephritis remained the most common conditions (accounting for 68.70% of incidence in 2023), whereas chronic kidney disease (48.61%) and kidney cancer (26.03%) constituted the primary sources of DALY burden. The distribution of diseases exhibited distinct age and sex patterns. Decomposition analysis indicated that for all diseases except congenital genitourinary anomalies, the reduction in DALYs was predominantly attributable to improvements in epidemiological factors, with contribution rates ranging from 58.10% to 83.94%. Conclusions The burden of urinary system diseases among children and adolescents in China decreased markedly between 1990 and 2023, largely driven by public health initiatives and advances in clinical diagnosis and treatment. Future prevention and control strategies should prioritize the evolving disease spectrum and implement precise interventions targeting key populations, such as adolescent females, adolescent males, and infants.

Key words: urinary system diseases, disease burden, temporal trend, decomposition analysis, children and adolescents

中图分类号:

顾信佳, 郑智慧, 梅伶俐, 郑金鑫, 刘太祥, 诸纪华. 1990—2023年中国儿童和青少年泌尿系统疾病负担研究[J]. 临床儿科杂志, 2026, 44(6): 546-555.

GU Xinjia, ZHENG Zhihui, MEI Lingli, ZHENG Jinxin, LIU Taixiang, ZHU Jihua. Burden of urinary system diseases in children and adolescents in China, 1990-2023[J]. Journal of Clinical Pediatrics, 2026, 44(6): 546-555.

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参考文献 37

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项目	1990年		2023年		1990—2023年
项目	发病人数	发病率/10万	发病人数	发病率/10万	发病人数总变化百分比(%)
总体	1 711 739 (1 264 132~2 314 199)	384.70 (284.10~520.09)	949 361 (709 979~1 280 017)	285.38 (213.42~384.78)	-44.54 (-69.32~1.26)
性别
女性	1 129 910 (837 315~1 510 942)	527.88 (391.18~705.89)	643 485 (475 565~861 497)	413.95 (305.93~554.19)	-43.05 (-68.53~2.89)
男性	581 829 (405 311~826 316)	251.97 (175.53~357.85)	305 875 (221 736~423 163)	172.61 (125.13~238.79)	-47.43 (-73.17~4.40)
疾病亚型
急性肾小球肾炎	85 998 (57 998~120 006)	19.33 (13.03~26.97)	29 786 (22 664~39 534)	8.95 (6.81~11.88)	-65.36 (-71.63~-57.02)
慢性肾脏病	86 827 (68 685~104 538)	19.51 (15.44~23.49)	58 281 (47 608~69 814)	17.52 (14.31~20.99)	-32.88 (-37.61~-28.17)
肾癌	5 378 (3 582~7 037)	1.21 (0.80~1.58)	4 389 (3 222~6 629)	1.32 (0.97~1.99)	-18.39 (-46.43~28.22)
尿路感染和间质性肾炎	1 023 471 (816 506~1 296 959)	230.02 (183.50~291.48)	652 114 (506 673~856 995)	196.03 (152.31~257.62)	-36.28 (-40.06~-31.45)
先天性泌尿生殖系统异常	153 936 (111 079~206 676)	34.60 (24.96~46.45)	51 786 (37 305~70 466)	15.57 (11.21~21.18)	-66.36 (-68.58~-64.11)
尿石症	356 130 (206 282~578 982)	80.04 (46.36~130.12)	153 005 (92 507~236 578)	45.99 (27.81~71.12)	-57.04 (-63.24~-48.28)

项目	1990年		2023年		1990—2023年
项目	DALYs	DALY率 /10万	DALYs	DALY率/10万	DALYs总变化百分比(%)
总体	715 577 (487 193~1 024 664)	160.82 (109.49~230.28)	132 422 (96 241~183 923)	39.81 (28.93~55.29)	-81.49 (-90.61~-62.25)
性别
女性	340 720 (205 315~528 520)	159.18 (95.92~246.92)	60 672 (39 047~94 372)	39.03 (25.12~60.71)	-82.19 (-92.61~-54.04)
男性	374 857 (216 713~607 668)	162.34 (93.85~263.16)	71 750 (47 891~106 089)	40.49 (27.02~59.87)	-80.86 (-92.12~-51.05)
疾病亚型
急性肾小球肾炎	123 045 (67 339~210 468)	27.65 (15.13~47.30)	8 039 (4 403~13 127)	2.42 (1.32~3.95)	-93.47 (-96.76~-86.49)
慢性肾脏病	392 238 (282 206~525 309)	88.15 (63.42~118.06)	64 370 (48 518~83 484)	19.35 (14.58~25.10)	-83.59 (-89.56~-76.17)
肾癌	88 024 (62 564~108 634)	19.78 (14.06~24.41)	34 473 (26 861~49 537)	10.36 (8.07~14.89)	-60.84 (-71.50~-45.56)
尿路感染和间质性肾炎	51 001 (39 514~62 584)	11.46 (8.88~14.07)	5 451 (4 551~6 457)	1.64 (1.37~1.94)	-89.31 (-91.84~-85.58)
先天性泌尿生殖系统异常	45 847 (24 854~94 931)	10.30 (5.59~21.33)	18 926 (11 122~29 568)	5.69 (3.34~8.89)	-58.72 (-74.55~-42.44)
尿石症	15 421 (10 715~22 737)	3.47 (2.41~5.11)	1 165 (785~1 749)	0.35 (0.24~0.53)	-92.45 (-94.68~-88.83)

1990—2023年中国儿童和青少年泌尿系统疾病负担研究

Burden of urinary system diseases in children and adolescents in China, 1990-2023

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