目的

分析1990-2021 年中国慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的疾病负担及2022-2050 年的变化趋势，以期为COPD 防治提供参考依据。

方法

提取全球疾病负担研究2021 数据库中1990-2021 年中国COPD 疾病负担、危险因素等相关数据，应用百分比变化及年估计变化百分比分析疾病负担演变情况，并对不同性别、年龄人群进行分层分析。 对所有风险因素所导致的死亡进行归因分析，使用贝叶斯年龄-时期-队列模型预测2022-2050 年COPD 疾病负担变化趋势。

结果

2021 年我国COPD 发病4 434 437.77 例，死亡1 285 433.17 例，伤残调整寿命年为23 640 320.96例年，分别较1990 年增加105.20%，3.84%和-9.42%。 1990-2021 年COPD 的年龄标准化发病率、年龄标准化病死率和年龄标准化伤残调整寿命年率呈现下降趋势，年估计变化百分比分别为-0.84%，-4.25%和-4.19%。 2021 年男性发病2 226 848.07 例，死亡752 026.94 例，伤残调整寿命年13 480 743.00例年，分别较1990 年增加112.81%、17.28%和-2.98%；女性发病2 207 589.70 例，死亡533 406.24例，伤残调整寿命年10 159 577.96 人年，分别较1990 年增加98.06%、-10.61%和-16.75%，显示出性别差异。 疾病负担随着年龄增长显著增加，男性发病和伤残调整寿命年高峰分别为65～69 岁和70～74 岁，女性为70～74 岁和80～84 岁；死亡高峰在80～84 岁，无性别差异。 导致COPD 死亡的危险因素随时间发生变化，近5 年吸烟为首位危险因素，男、女性最常见危险因素分别为吸烟和颗粒物污染。预计2022-2050 年COPD 的年龄标准化发病率、年龄标准化病死率、年龄标准化伤残调整寿命年率将持续下降，2050 年分别将下降至139.71/10 万、15.80/10 万和362.03/10 万。

结论

我国COPD 疾病负担仍较为严峻，应针对高危人群及风险因素制定有效防治策略。

Objective

To analyze the disease burden of chronic obstructive pulmonary disease（COPD） in China from 1990 to 2021，and the trend of change from 2022 to 2050，in order to provide a reference for the prevention and control of COPD.

Methods

Chinese disease burden and risk factors of COPD from 1990 to 2021 were extracted in the Global Burden of Disease 2021.Percentage change and estimated annual percentage change were applied to analyze the evolution of the disease burden.And which in different sex and age groups was also analyzed.Deaths due to all risk factors were attributed and Bayesian age-periodcohort modeling was used to predict trends of COPD from 2022 to 2050.

Results

The number of incident，death，disability-adjusted life years（DALYs） in 2021 were 4 434 437.77，1 285 433.17 and 23 640 320.96，which was 105.20%，3.84%，and -9.42% higher than 1990，reapectively.The age-standardized rate of incident，death and DALYs showed a downward trend from 1990 to 2021，estimated annual percentage change was -0.84%，-4.25% and -4.19%，reapectively.In 2021，the number of incident，death，disability-adjusted life years（DALYs） were 2 226 848.07，752 026.94 and 13 480 743.00 among males，which was 112.81%，17.28% and -2.98% higher than 1990，reapectively.For females，there were 2 207 589.70 cases of incidence and 533 406.24 deaths，with 10 159 577.96 DALYs，representing 98.06%，-10.61% and -16.75% higher than 1990，reapectively.Indicating a gender difference.Disease burden increased significantly with age，with the peak of incidence and DALYs for males were in the 65-69 and 70-74 years old，and for females in the 70-74 and 80-84 years old.The peak in deaths for both genders was in the 80-84 age group，with no gender difference.The risk factors leading to COPD-related deaths have changed over time，with smoking being the leading risk factor in recent five years，and the most common risk factors for males and females being smoking and particulate matter pollution，respectively.The age-standardized rate of incidence，death and DALYs will continued decrease from 2022 to 2050.，with expected decreases to 139.71/100 000、15.80/100 000 and 362.03/100 000 by 2050，respectively.

Conclusion

The disease burden of COPD in China remains severe，and effective prevention and treatment strategies should beformulated for high-risk populations and risk factors.