【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。更多还原

【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.更多还原