【摘要】 目的 全球老龄化越来越严重，而老年胆囊及胆道疾病（OGBD）一直是困扰老年人群（>65岁）的一种常见疾病。本研究旨在利用2021年全球疾病负担研究数据库（global burden of disease study 2021,GBD 2021）数据，探索全球OGBD总体负担、变化趋势以及预测。方法 我们分析了GBD 2021的研究数据，主要分析指标为：204个国家和地区OGBD的患病率、发病率、死亡率和伤残调整生命年（DALYs）。数据分析包括相对变化计算以及年度百分比变化（APC）和估计的年度百分比变化（EAPC），并利用ARIMA及ES模型预测到2050年的趋势。结果 1990—2021年，OGBD的发病人数（7 835 812～16 647 254）人、患病人数（40 413 246～85 146 547）人、死亡人数（54 528～105 358）人及DALYs(1 650 007～3 133 699)人大幅增加，增幅都在1倍以上。然而，30多年间粗率指标轻微下降，发病率为每10万人口4 824.38～4 287.53,EAPC为-0.33(95%CI-0.39--0.28)；患病率为每10万人口24 128.97～21 131.60,EAPC为-0.41(95%CI-0.45-0.36)；死亡率为每10万人口29.49～22.98,EAPC为-0.62(95%CI-0.77--0.47);DALYs为每10万人口962.02～754.66例，EAPC为-0.73(95%CI-0.80--0.65)。而发病人口以女性居多，发病率、DALYs及死亡率随着年龄的增大而增加。在5个社会人口指数（SDI）区域中，高SDI区域的OGBD患病率、发病率、死亡率及DALYs，分别估计为每10万人口24 691.83、5 852.12、26.45、825.22，其中SDI发病率及DALYs最高，其与SDI指数呈正相关。危险因素方面，其与抽烟及身体质量指数（BMI）高相关。我们通过ES及ARIMA模型预测发现胆囊及胆道疾病的发病率、患病率、死亡率及DALYs将进一步提高。结论 过去的32年来，全球OGBD的负担显著增加，尤其在高SDI区域，随着年龄的增加各项指标越发严峻，预测结果也提示了以后的疾病负担会越来越重。因此我们应该重视OGBD，控制其危险因素，并加强预防。更多还原

【Abstract】 Objective The global aging population is growing rapidly, and gallbladder and biliary diseases have been a common issue affecting the elderly. This study will use data from the Global Burden of Disease(GBD) 2021 to explore the overall burden, trends, and predictions of gallbladder and biliary diseases in the elderly(over 65 years) worldwide. Methods We analyzed data from the GBD 2021 study, focusing on prevalence, incidence, mortality, and disability-adjusted life years(DALYs) in 204 countries and regions. The data analysis included calculating relative changes, annual percentage change(APC), and estimated annual percentage change(EAPC), both based on frontier analysis, using an ARIMA model and ES model to predict trends until 2050. Results From 1990 to 2021, the number of elderly people with gallbladder and biliary diseases increased significantly: incidence cases rose from 7 835 812 to 16 647 254, prevalence cases from 40 413 246 to 85 146 547, deaths from 54 528 to 105 358, and DALYs from 1 650 007 to 3 133 699, all more than doubled. However, the estimated age-standardized rate indicators showed a slight decline over 30 years(incidence rate per 100 000 population decreased from 4 824.38 to 4 287.53, EAPC-0.33(95%CI-0.39 to-0.28); prevalence rate decreased from 24 128.97 to 21 131.60, EAPC-0.41(95%CI-0.45 to-0.36); mortality rate decreased from 29.49 to 22.98, EAPC-0.62(95%CI-0.77 to-0.47); DALYs rate decreased from 962.02 to 754.66, EAPC-0.73(95%CI-0.80 to-0.65). The incidence was higher among females, and the incidence rate, DALYs, and mortality increased with age. Among the five Socio-Demographic Index(SDI) areas, in 2021, the prevalence, incidence, mortality, and DALYs of elderly gallbladder and biliary diseases in high SDI areas were estimated to be 24 691.83, 5 852.12, 26.45 and 825.22 cases per 100 000 population respectively. Highmiddle SDI areas had the highest incidence and DALYs, which were correlated with the SDI index. Regarding risk factors, there was a high correlation with smoking and high bady mass index(BMI), and the BMI was the main risk factor. Through ES and ARIMA predictions, we found that the rate of incidence, prevalence, mortality, and DALYs of biliary diseases would gradually increase. Conclusion In summary, the global burden of OGBD has significantly increased over the past 32 years, especially in high SDI areas, and indicators have worsened with age. The findings highlight the need to focus on OGBD, control risk factors, and strengthen prevention.更多还原