卫生研究

目的 描述中国十省(自治区)18岁及以上成年居民14年来的几种慢性病共病患病情况和流行趋势，并分析其共病模式。方法 根据“中国发展与营养健康影响因素”(“中国健康与营养调查”)2009、2015、2018和2023年共4轮随访调查的17 000名成年人的空腹血液生理生化检测、体格测量及问卷调查获取肥胖、高血压、糖尿病、血脂异常、高尿酸等慢性病的相关指标和疾病史信息，对于有2种及2种以上慢病状况的人群患病率及4轮调查的变化趋势进行描述性分析，识别并比较患慢性病共病的几种常见组合。结果 来自17 000名成年居民的35 712个观测样本，各轮慢性病共病患病率从2009年的28.3%上升到2023年的38.9%,增长了10.6个百分点，不同性别、年龄段和城乡人口的患病率都呈上升趋势，而城乡人群慢性病共病的患病率随着时间变化逐渐趋于相同。对慢性病共病情况的各种模式进行分组后，发现14年间慢性病共病患病率的上升趋势，成年人的主要共病模式是高血压合并血脂异常和(或)其它慢性病状况，老年人共病模式以高血压合并血脂异常共病模式为主而青中年人以血脂异常合并肥胖或高尿酸为主。结论 人群患慢性病状况多为组合在一起出现，不同年龄段和性别的人群因其生理差异性所患共病的模式存在差异。

OBJECTIVE To describe the prevalence and epidemic trends of several chronic multimorbidy among adult residents in 10 provinces(autonomous regions)of China over the past 14 years, and to analyze their multimorbidity patterns.METHODS According to the fasting blood physiological and biochemical tests, physical measurements and questionnaires of 17 000 adult residents aged 18 years and above who were surveyed in 4 rounds of follow-up surveys in 2009, 2015, 2018 and 2023, the relevant indicators and disease history information of obesity, hypertension, diabetes mellitus, dyslipidemia, hyperuricemia, and various chronic diseases were obtained. Descriptive analysis was carried out to identify and compare several common combinations of multimorbidity in the population with 2 or more chronic disease conditions and the changing trends of 4 rounds of surveys.RESULTS 35 712 observations from 17 000 adults revealed that the prevalence of multimorbidity in each round rose from 28.3% in 2009 to 38.9% in 2023, an increase of 10.6 percent. The prevalence of multimorbidity in different gender, age groups, and urban/rural populations showed an upward trend, while the prevalence of multimorbidity in urban and rural populations gradually tended to be the same over time. After grouping various patterns of multimorbidity, it was found that the prevalence of multimorbidity increased over the past 14 years. The main multimorbidity pattern in adults was hypertension combined with dyslipidemia and(or) other chronic disease conditions. The elderly multimorbidity pattern was mainly hypertension combined with dyslipidemia, while young and middle-aged people mainly had dyslipidemia combined with obesity or hyperuricemia.CONCLUSION The chronic disease status of the population is mostly combined. There are differences in the multimorbidity patterns of different age groups and genders due to their physiological differences.