摘要目的:分析1990至2021年全球总体及中国炎症性肠病(IBD)患病人数、发病率、死亡率、伤残调整生命年(DALY)、健康生命损失年(YLD)和早死生命损失年(YLL)变化，预测未来全球总体及中国IBD发病人数、DALY变化趋势。方法:应用描述性流行病学方法。从全球疾病负担(GBD)2021数据库收集1990至2021年全球总体及中国的IBD疾病负担指标，包括患病率、发病率、死亡率、DALY等，并分析年龄、性别分布及变化趋势。年龄标准化率以GBD估计的世界标准人口年龄结构进行标准化后进行计算。采用自回归积分滑动平均模型对2022至2030年全球及中国IBD发病人数和DALY进行预测。结果:1990和2021年，全球IBD患病人数分别为217.02万例和383.01万例，中国IBD患病人数分别为6.21万例和16.81万例；全球IBD粗发病率和年龄标准化发病率分别为3.74/10万、4.22/10万和4.75/10万、4.45/10万，中国IBD粗发病率和年龄标准化发病率分别为0.71/10万、0.74/10万和1.75/10万、1.40/10万；全球IBD粗死亡率和年龄标准化死亡率分别为0.40/10万、0.60/10万和0.54/10万、0.52/10万，中国IBD粗死亡率和年龄标准化死亡率分别为0.37/10万、0.75/10万和0.40/10万、0.33/10万。与1990年比较，2021年全球IBD的粗DALY、粗YLD和粗YLL均增高，分别为151.08万人年比94.89万人年、57.92万人年比33.09万人年、93.16万人年比61.80万人年。年龄标准化DALY、年龄标准化YLD、年龄标准化YLL均降低，分别为18.07/10万比21.54/10万、6.79/10万比7.27/10万、11.27/10万比14.27/10万。与1990年比较，2021年中国的粗YLD和年龄标准化YLD均增高(2.69万人年比1.01万人年、1.47/10万比0.91/10万)，粗DALY、年龄标准化DALY和粗YLL、年龄标准化YLL均降低(13.69万人年比16.22万人年、7.68/10万比18.38/10万和11.0万人年比15.2万人年、6.21/10万比17.47/10万)。1990至2021年，男性和女性的IBD年龄标准化发病率、患病率总体均呈上升趋势。IBD发病率的性别差异较小，全球男性的IBD年龄标准化发病率均略高于女性，中国男性的IBD年龄标准化发病率与女性相似。全球、中国女性年龄标准化患病率均略高于男性。1990至2021年IBD年龄标准化发病率的年估算百分比变化(EAPC)在全球为0.24(95%置信区间0.16～0.31)，在中国为1.55(95%置信区间1.25～1.86)；年龄标准化DALY的EAPC在全球为－0.50(95%置信区间－0.58～－0.41)，在中国为－2.71(95%置信区间－2.99～－2.43)，发病年龄结构趋向中老年。预测2030年全球总体IBD年新发病例数将升至410 100例，中国将降至21 184例，全球IBD的DALY将升至1 670 527人年，中国将为140 563人年。结论:1990至2021年，全球总体及中国的IBD患病人数与发病率均持续上升，IBD发病年龄趋于老年化，全球及中国在应对IBD方面仍面临诸多严峻挑战。

abstractsObjective:To analyze the changes in the number of patients, incidence, mortality rate, disability-adjusted life year (DALY), years lived with disability (YLD), and years of life lost due to premature mortality (YLL) globally and in China from 1990 to 2021, and to predict future trends in the number of patients and DALY of inflammatory bowel disease (IBD) globally and in China.Methods:Descriptive epidemiology was applied. Data on globally and Chinese IBD burden indicators, including prevalence, incidence, mortality, DALY, YLL, and YLD were collected from the Global Burden of Disease (GBD) 2021 Database from 1990 to 2021, and the trends in the changes and distributions of age and gender were analyzed. The age-standardized rate was standardization based on the world standard population age structure estimated by GBD. Auto-regressive integrated moving average model was used to predict the number of IBD patients and DALY globally and in China from 2022 to 2030.Results:In 1990 and 2021, the global number of IBD patients was 2.170 2 and 3.830 1 million, respectively, while in China which was 62 100 and 168 100, respectively. The global crude incidence rate and age-standardized incidence rate were 3.74/100 000, 4.22/100 000, 4.75/100 000, and 4.45/100 000, respectively. The crude incidence rate and age-standardized incidence rate in China were 0.71/100 000, 0.74/100 000 and 1.75/100 000, 1.40/100 000, respectively. In 1990 and 2021, the global crude mortality rate and age-standardized mortality rate of IBD were 0.40/100 000, 0.60/100 000 and 0.54/100 000, 0.52/100 000, respectively; the crude mortality rate and age-standardized mortality rate in China were 0.37/100 000, 0.75/100 000 and 0.40/100 000, 0.33/100 000, respectively. Compared with those in 1990, the global crude DALY, YLD and YLL of IBD all increased in 2021, which were 1 510.8 thousand person-years vs. 948.9 thousand person-years, 579.2 thousand person-years vs. 330.9 thousand person-years, 931.6 thousand person-years vs. 618.0 thousand person-years; the age-standardized DALY, YLD and YLL all decreased, which were 18.07/100 000 vs. 21.54/100 000, 6.79/100 000 vs. 7.27/100 000, 11.27/100 000 vs. 14.27/100 000, respectively. Compared with those in 1990, the crude YLD and the age-standardized YLD in China both increased (26.9 thousand person-years vs. 10.1 thousand person-years, 1.47/100 000 vs. 0.91/100 000), while the crude DALY, the age-standardized DALY, crude YLL and the age-standardized YLL all decreased (136.9 thousand person-years vs. 162.2 thousand person-years, 7.68/100 000 vs. 18.38/100 000, 110 thousand person-years vs. 152 thousand person-years, 6.21/100 000 vs. 17.47/100 000).From 1990 to 2021, male and female age-standardized incidence and prevalence of IBD were all in upward trend. The difference in the incidence of IBD between males and females was relatively small, and the global age-standardized incidence of IBD in males were slightly higher than those in females, while in China the rates are similar between the two genders. The global and Chinese age-standardized prevalence in females were slightly higher than those in males. From 1990 to 2021, the estimated annual percentage change (EAPC) of age-standardized IBD incidence in global and China were 0.24 (95% confidence interval (95% CI): 0.16 to 0.31) and 1.55 (95% CI: 1.25 to 1.86), respectively; the EAPC of age-standardized DALY in global and China were -0.50 (95% CI: -0.58 to -0.41) and -2.71 (95% CI: -2.99 to -2.43), respectively. The age distribution of disease onset shifted towards middle-aged and old population. It was predicted that by 2030, the annual number of new IBD cases in global would increase to 410 100, while in China, it would decrease to 21 184. Furthermore, the global DALY of IBD would increase to 1 670 527 person-year, and in China which would be 140 563 person-year. Conclusions:From 1990 to 2021, the global and Chinese number of patients and the incidence of IBD both sustained increase. The age of IBD onset towards older population. The incidence trend of IBD was aging, with significant gender bias. The global community and China continue to face many severe challenges in IBD.