【摘要】 目的 基于全球疾病负担2021(GBD 2021)分析1990年至2021年中国0～14岁儿童先天性唇腭裂（OFCs）疾病负担变化及趋势。方法 基于GBD 2021数据库提取1990年至2021年中国0～14岁儿童OFC疾病的发病、患病、伤残调整生命年（DALYs）等数据，采用Joinpoint回归模型计算OFC的年度变化百分比和平均年度变化百分比（AAPC），分析其长期变化趋势。同时预测2022年至2050年中国儿童OFC的DALY变化趋势。结果 1990年至2021年中国儿童OFC的发病率、患病率和DALYs率均呈显著下降趋势，DALYs率下降趋势尤为明显。2021年中国儿童OFC疾病的发病数、患病数和DALY数分别为1.20万人、11.67万人和1.61万人年，与1990年相比分别下降了71.43%、43.97%和97.06%;2021年的标化发病率、标化患病率和标化DALY率分别为3.87/10万、35.25/10万和5.04/10万，与1990年相比分别下降了58.86%、24.76%和95.88%。1990年至2021年中国儿童OFC疾病负担均呈显著下降趋势。男孩和女孩标化发病率的AAPC分别为-3.04%(95%CI:-3.77%～-2.31%,P<0.001),-2.78%(95%CI:-3.43%～-2.12%,P<0.001)；标化患病率的AAPC分别为-1%(95%CI:-1.16%～-0.85%,P<0.001),-0.96%(95%CI:-1.10%～-0.81%,P<0.001)；标化DALY率的AAPC分别为-9.97%(95%CI:-10.51%～-9.43%,P<0.001),-10.24%(95%CI:-10.93%～-9.55%,P<0.001)。预测2050年<5岁年龄组的DALY率将下降至6.05/10万（3.67/10万～9.18/10万），较2022年下降56.82%；预测2050年5～14岁年龄组的DALY率将下降至1.87/10万（1.13/10万～2.93/10万），较2022年下降2.10%。结论 1990年至2021年中国儿童OFC疾病发病和患病情况均呈显著下降趋势，其中DALY率下降最快，且与女孩相比，男孩疾病负担的下降趋势较为明显。因此，未来应高度重视儿童的防治和筛查工作，进一步加强符合我国国情的出生缺陷防治策略，我国OFC的防治重点应从降低病死率转向全面改善患儿的生存质量。更多还原

【Abstract】 Objective Based on the Global Burden of Disease Study 2021(GBD 2021), this study analyzes the changes and trends in the disease burden of orofacial clefts(OFCs) among children aged 0–14 years in China from 1990 to 2021. Methods Data on the incidence, prevalence, and disability-adjusted life years(DALYs) of OFC in Chinese children aged 0–14 years from 1990 to 2021 were extracted from the GBD 2021 database. The Joinpoint regression model was used to calculate the annual percent change and average annual percent change(AAPC) of OFC, and to analyze its long-term trends. The trend of DALY for OFC among Chinese children from 2022 to 2050 was also predicted. Results From 1990 to 2021, the incidence rate, prevalence rate, and DALY rate of OFC in Chinese children showed a significant downward trend, with the decline in the DALY rate being particularly pronounced. In 2021, the number of incident cases, prevalent cases, and DALYs of OFC in children were 12 000, 116 700, and 16 100 person-years, respectively, representing decreases of 71.43%, 43.97%, and 97.06% compared with 1990. The age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate in 2021 were 3.87/100 000, 35.25/100 000, and 5.04/100 000, respectively, which decreased by 58.86%, 24.76%, and 95.88% compared with 1990. From 1990 to 2021, the disease burden of OFC in Chinese children showed a significant downward trend. The AAPC of the age-standardized incidence rate for boys and girls were-3.04%(95%CI:-3.77%–-2.31%, P<0.001) and-2.78%(95%CI:-3.43%–-2.12%, P<0.001), respectively; the AAPC of the age-standardized prevalence rate were-1%(95%CI:-1.16%–-0.85%, P<0.001) and-0.96%(95%CI:-1.10%–-0.81%, P<0.001), respectively; the AAPC of the age-standardized DALY rate were-9.97%(95%CI:-10.51%–-9.43%, P<0.001) and-10.24%(95%CI:-10.93%–-9.55%, P<0.001), respectively. It is predicted that the DALY rate in the <5 years age group will decrease to 6.05/100 000(3.67/100 000–9.18/100 000) by 2050, a decline of 56.82% compared with 2022; the DALY rate in the 5–14 years age group will decrease to 1.87/100 000(1.13/100 000–2.93/100 000) by 2050, a decline of 2.10% compared with 2022. Conclusion From 1990 to 2021, the incidence and prevalence of OFC in Chinese children showed a significant downward trend, with the DALY rate declining the fastest. Compared with girls, the decline in disease burden was more pronounced in boys. Therefore, greater attention should be paid to the prevention, treatment, and screening of OFC in children in the future, and strategies for the prevention and treatment of birth defects in line with China’s national conditions should be further strengthened. The focus of OFC prevention and treatment in China should shift from reducing mortality to comprehensively improving the quality of life of affected children.更多还原