伊朗沙希德·贝赫什提医科大学Ali-Asghar Kolahi团队研究了1990-2019年间204个国家和地区的慢性阻塞性肺疾病负担及其归因风险因素。这一研究成果发表在2022年7月27日出版的《英国医学杂志》上。

为了报告1990至2019年间全球、地区和国家按年龄、性别和社会人口统计指数的慢性阻塞性肺疾病（COPD）负担及其归因风险因素，研究组针对2019年全球疾病负担研究进行了一项系统分析。

1990至2019年间，研究组从204个国家和地区的2019年全球疾病负担项目中检索了COPD的患病、死亡和残疾调整生命年（DALY）及其归因风险因素的数据。每项估计均提出每10万人的计数和比率，以及95%的不确定区间。

2019年，全球报告了2.123亿例COPD流行病例，其中COPD导致330万人死亡，7440万DALY。COPD的全球年龄标准化点患病率、死亡率和DALY率分别为每10万人2638.2、42.5和926.1，与1990年相比分别减少8.7%、41.7%和39.8%。

2019年，丹麦（4299.5）、缅甸（3963.7）和比利时（3927.7）的COPD年龄标准化点患病率最高。在整个研究期间，埃及（62.0%）、格鲁吉亚（54.9%）和尼加拉瓜（51.6%）的年龄标准化点患病率增幅最大。2019年，尼泊尔（182.5）和日本（7.4）的每10万人年龄标准化死亡率分别最高和最低 ，尼泊尔（3318.4）和巴巴多斯（177.7）的每10万人年龄标准化DALY比率分别最高和最低 。

在男性中，COPD的整体DALY比率在85-89岁之前增加，然后随着年龄的增长而下降，而在女性中，该比率在最老年龄组之前增加（≥95岁）。从地区来看，社会人口统计指数与COPD的年龄标准化DALY率之间存在整体倒V型关联。吸烟（46.0%）、环境颗粒物污染（20.7%）和职业性接触颗粒物、气体和烟雾（15.6%）是导致COPD DALY率的主要因素。

研究结果表明，虽然COPD的负担在减轻，但该疾病仍然是一个重大公共卫生问题，尤其是在社会人口指数较低的国家。预防方案应侧重于戒烟、改善空气质量和减少职业暴露，以进一步减轻COPD的负担。

附：英文原文

Title: Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019

Author: Saeid Safiri, Kristin Carson-Chahhoud, Maryam Noori, Seyed Aria Nejadghaderi, Mark J M Sullman, Javad Ahmadian Heris, Khalil Ansarin, Mohammad Ali Mansournia, Gary S Collins, Ali-Asghar Kolahi, Jay S Kaufman

Issue&Volume: 2022/07/27

Abstract:

Objective To report the global, regional, and national burden of chronic obstructive pulmonary disease (COPD) and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index.

Design Systematic analysis.

Data source Global Burden of Disease Study 2019.

Main outcome measures Data on the prevalence, deaths, and disability adjusted life years (DALYs) of COPD, and its attributable risk factors, were retrieved from the Global Burden of Disease 2019 project for 204 countries and territories, between 1990 and 2019. The counts and rates per 100000 population, along with 95% uncertainty intervals, were presented for each estimate.

Results In 2019, 212.3 million prevalent cases of COPD were reported globally, with COPD accounting for 3.3 million deaths and 74.4 million DALYs. The global age standardised point prevalence, death, and DALY rates for COPD were 2638.2 (95% uncertainty intervals 2492.2 to 2796.1), 42.5 (37.6 to 46.3), and 926.1 (848.8 to 997.7) per 100000 population, which were 8.7%, 41.7%, and 39.8% lower than in 1990, respectively. In 2019, Denmark (4299.5), Myanmar (3963.7), and Belgium (3927.7) had the highest age standardised point prevalence of COPD. Egypt (62.0%), Georgia (54.9%), and Nicaragua (51.6%) showed the largest increases in age standardised point prevalence across the study period. In 2019, Nepal (182.5) and Japan (7.4) had the highest and lowest age standardised death rates per 100000, respectively, and Nepal (3318.4) and Barbados (177.7) had the highest and lowest age standardised DALY rates per 100000, respectively. In men, the global DALY rate of COPD increased up to age 85-89 years and then decreased with advancing age, whereas for women the rate increased up to the oldest age group (≥95 years). Regionally, an overall reversed V shaped association was found between sociodemographic index and the age standardised DALY rate of COPD. Factors contributing most to the DALYs rates for COPD were smoking (46.0%), pollution from ambient particulate matter (20.7%), and occupational exposure to particulate matter, gases, and fumes (15.6%).

Conclusions Despite the decreasing burden of COPD, this disease remains a major public health problem, especially in countries with a low sociodemographic index. Preventive programmes should focus on smoking cessation, improving air quality, and reducing occupational exposures to further reduce the burden of COPD.

DOI: 10.1136/bmj-2021-069679

Source: https://www.bmj.com/content/378/bmj-2021-069679