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中国 COPD 疾病负担的全球变化:1990 年至 2019 年以及未来疾病负担趋势的预测。

Global disease burden of COPD from 1990 to 2019 and prediction of future disease burden trend in China.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.

出版信息

Public Health. 2022 Jul;208:89-97. doi: 10.1016/j.puhe.2022.04.015. Epub 2022 Jun 18.

Abstract

OBJECTIVES

This study aimed to assess and predict the disease burden attributable to chronic obstructive pulmonary disease (COPD) in a timely, comprehensive, and reliable manner, thereby mitigating the health hazards of COPD.

STUDY DESIGN AND METHODS

Data on the disease burden owing to COPD from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) Study 2019. Linear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. Non-parametric tests were used for subgroup analysis. The Bayesian age-period-cohot (BAPC) model integrated nested Laplace approximations to predict the disease burden over the next 25 years. Sensitivity analysis was performed using the Norpred APC model.

RESULTS

Globally, the COPD-related age-standardized incidence rate decreased from 216.48/100,000 in 1990 to 200.49/100,000 in 2019, with an EAPC of -0.33. But the number of new cases increased from 8,722,966 in 1990 to 16, 214, 828 in 2019. Trends in prevalence, deaths, and disability-adjusted life years (DALYs) were the same as incidence. There were significant differences in disease burden between the genders and all age groups (P < 0.05) in China. The projections suggested that the COPD-related number of new cases and deaths in China would increase by approximately 1.5 times over the next 25 years.

CONCLUSIONS

The number of incidence, prevalence, deaths, and DALYs had all increased in China in the past and would continue to grow over the next 25 years. Therefore, measures should be taken to target risk factors and high-risk groups.

摘要

目的

本研究旨在及时、全面、可靠地评估和预测慢性阻塞性肺疾病(COPD)的疾病负担,从而减轻 COPD 的健康危害。

研究设计与方法

从 2019 年全球疾病负担(GBD)研究中提取了 1990 年至 2019 年 COPD 疾病负担的数据。线性回归分析用于计算年龄标准化率的估计年变化百分比(EAPC)。非参数检验用于亚组分析。贝叶斯年龄-时期-队列(BAPC)模型集成嵌套拉普拉斯近似法预测未来 25 年的疾病负担。使用 Norpred APC 模型进行敏感性分析。

结果

全球范围内,COPD 相关的年龄标准化发病率从 1990 年的 216.48/100,000 下降到 2019 年的 200.49/100,000,EAPC 为-0.33。但新发病例数从 1990 年的 8,722,966 例增加到 2019 年的 16,214,828 例。患病率、死亡率和伤残调整生命年(DALYs)的趋势与发病率相同。中国不同性别和各年龄段的疾病负担均存在显著差异(P<0.05)。预测结果表明,未来 25 年中国 COPD 相关新发病例和死亡人数将增加约 1.5 倍。

结论

过去中国的发病率、患病率、死亡率和 DALYs 均有所增加,未来 25 年还将继续增长。因此,应采取措施针对危险因素和高危人群。

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