1990-2019年全球60岁及以上人群慢性阻塞性肺疾病的疾病负担分解分析  

A decomposition analysis of the burden of chronic obstructive pulmonary disease among individuals aged 60 and above,1990-2019:a global perspective

作　　者：王文星[1,2] 阿不力米提·买买提 王璐 再那吾东·玉山[4] 蒋红 高发水 Wang Wenxing;Alemiti·Maimaiti;Wang Lu;Zainaudong·Yushan;Jiang Hong;Gao Fashui(School of Public Health,Xinjiang Medical University,Urumqi 830017,China;Office of the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Emergency Department of Xinjiang Uygur Autonomous Region Infectious Diseases Hospital,Urumqi 830000,China;Office of Chinese Center for Disease Control and Prevention,Beijing 102206,China;Neurology Department of the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830017 [2]新疆医科大学第六附属医院办公室,乌鲁木齐830000 [3]新疆维吾尔自治区传染病医院急诊科,乌鲁木齐830000 [4]中国疾病预防控制中心办公室,北京102206 [5]新疆医科大学第二附属医院神经内科,乌鲁木齐830000

出　　处：《中华流行病学杂志》2025年第4期676-687,共12页Chinese Journal of Epidemiology

基　　金：新疆医科大学医学科学研究所开放课题重点研究项目(YXYJ20230104);新疆维吾尔自治区社会科学基金(2023BRK069)。

摘　　要：目的分析1990-2019年全球≥60岁人群慢性阻塞性肺疾病(COPD)年龄标化的发病率、伤残调整寿命年(DALY)率和死亡率及变化趋势。推算人口增长、年龄结构改变及流行病学改变对全球≥60岁人群COPD发病人数、DALY数和死亡人数改变的影响。方法数据来源于2019年全球疾病负担研究,采用Joinpoint回归模型计算平均年变化百分比(AAPC)及其95%不确定性区间(UI)。通过分解分析,将全球≥60岁人群COPD发病人数、DALY数和死亡人数的变化归因于人口增长、年龄结构改变和流行病学改变,并分析不同影响因素的贡献大小,找出主要影响因素。结果1990-2019年,全球≥60岁人群COPD年龄标化的发病率、DALY率和死亡率均呈下降趋势,AAPC分别为-0.12%(95%UI:-0.13%~-0.11%)、-1.69%(95%UI:-1.80%~-1.58%)和-1.77%(95%UI:-1.89%~-1.64%);人口增长、年龄结构改变和流行病学改变3个分解因素对全球≥60岁人群COPD发病人数、DALY数和死亡人数改变的总体贡献的数值(贡献比例)分别为563.10万(112.55%),1431.46万人年(33.08%)和79.94万(35.76%)。其中人口增长的贡献数值(贡献比例)分别为564.34万(112.80%)、3977.42万人年(91.92%)和207.76万(92.93%),年龄结构改变的贡献数值(贡献比例)分别为322.76万(6.45%)、223.05万人年(5.15%)和26.56万(11.88%),流行病学改变的贡献数值(贡献比例)分别为-33.52万(-6.70%)、-2769.00万人年(-64.00%)和-154.38万(-69.05%)。结论1990-2019年全球≥60岁人群COPD年龄标化的发病率、DALY率和死亡率总体呈下降趋势。人口增长、年龄结构改变和流行病学改变3个分解因素对全球≥60岁人群COPD发病人数、DALY数和死亡人数改变的总体贡献为正向,且对发病人数改变的贡献较大。从单个因素的贡献来看,人口增长对≥60岁人群COPD发病人数、DALY数和死亡人数改变的贡献比例均高于其他2个因素,流行病学改变的贡献均为负向。Objectives To calculate the age-standardized incidence rate,disability-adjusted life years(DALY)rate,and mortality rate of chronic obstructive pulmonary disease(COPD)among individuals aged≥60 years globally from 1990 to 2019,and analyze their trends.To assess the impact of population growth,changes in age structure,and epidemiological changes on global changes in COPD incidence,DALYs,and deaths among individuals aged≥60 years.Methods The data were derived from the 2019 Global Burden of Disease study.The Joinpoint regression model was used to calculate the average annual percentage change(AAPC)and its 95%uncertainty interval(UI).Through decomposition analysis,the changes in the number of COPD cases,DALYs,and deaths among individuals aged≥60 years globally were attributed to three main factors:population growth,changes in age structure,and epidemiological changes.The contributions of these different factors were analyzed to identify the important factor driving the changes.Results From 1990 to 2019,the age-standardized incidence rate,DALY rate,and mortality rate of COPD in the global population aged≥60 years all showed a decreasing trend,with AAPCs of-0.12%(95%UI:-0.13%--0.11%),-1.69%(95%UI:-1.80%--1.58%),and-1.77%(95%UI:-1.89%--1.64%),respectively.The overall contributions of population growth,changes in age structure,and epidemiological changes to the changes in the number of COPD cases,DALYs,and deaths in the global population aged≥60 years were 5.631 million(112.55%),14.315 million person-years(33.08%),and 799400(35.76%),respectively.Specifically,the contributions of population growth were 5.643 million(112.80%),39.774 million person-years(91.92%),and 2.078 million(92.93%)for incidence,DALYs,and deaths,respectively.The contributions of changes in age structure were 3.228 million(6.45%),2.231 million person-years(5.15%),and 265600(11.88%)for incidence,DALYs,and deaths,respectively.The contributions of epidemiological changes were-335200(-6.70%),-27.690 million person-years(-64.00%),and-1.544 million(-6

关 键 词：慢性阻塞性肺疾病 全球疾病负担 回归分析 数据解释与统计 伤残调整寿命年 

分 类 号：R563.9[医药卫生—呼吸系统]