Abstract: Background　Chronic obstructive pulmonary disease （COPD） is one of the most severe diseases affecting people's health in the world.Hundreds of millions of people suffer from the pain and harm caused by COPD every day.In the background of high incidence，mortality and disability rate around the globe，COPD mainly affects rural areas in the north of China，but there are few comprehensive reports of COPD death and premature death in these areas.Objective　To analyze the trend of death and premature death caused by COPD in rural areas of Liaoning Province from 2009 to 2016，and make effective prediction，so as to provide a scientific basis for COPD prevention and control.Methods　The death data of Zhangwu Center for Disease Control and Prevention and Fengcheng Center for Disease Control and Prevention from 2009 to 2016 and the population data of Zhangwu County and Fengcheng City from public security departments were collected.The mortality rate，standardized mortality rate，total mortality rate，standardized total mortality rate，premature mortality rate，standardized premature mortality rate，premature death probability，total premature mortality rate，standardized total premature mortality rate，total premature death probability and the annual percentage change（APC）were calculated.COPD mortality rate，standardized mortality rate，total mortality rate，standardized total mortality rate，premature mortality rate，standardized premature mortality rate，premature death probability，total premature mortality rate，standardized total premature mortality rate，total premature death probability were analyzed and predicted by using Joinpoint regression and grey model GM（1，1）．Results　 In rural areas of Liaoning Province from 2009 to 2016，the number of deaths from COPD was 1 912，and the number of premature deaths was 389，accounting for 20.35% of deaths from COPD.The mortality and standardized mortality rates of COPD were significantly higher in females than those in males（P<0.001）．From 2009 to 2016，the standardized mortality rate and the standardized total mortality rate in females decreased by year（P<0.05） and premature mortality and standardized total premature mortality in males showed a downward trend by year（P<0.05）．The total premature death probability of COPD decreased from 0.83% in 2009 to 0.77% in 2016.There was a gap of 0.58% between the data of 2016 and the control target of 2030（1.00%）in terms of the probability of premature death in men，and the probability of premature death in women is 0.28% higher than the control target of 2030（1.12%）．The results of GM（1，1） prediction showed that the total mortality of COPD and the total premature mortality of COPD decreased by year（P<0.001）．The MAPE of each model was from 1.18% to 8.76%.Conclusion　In the rural areas of Liaoning Province，the mortality and premature mortality of COPD decreased from 2009 to 2016，but future predictions showed that the mortality and premature mortality rate in men and the total mortality of COPD increased by year.Therefore，targeted preventions should be taken to reduce residents' exposure to risk factors and reduce the harm caused by COPD.

Key words: Pulmonary disease, chronic obstructive；Mortality；Mortality, premature；Trend analysis；Grey models

摘要： 背景　慢性阻塞性肺疾病（COPD）是世界上严重影响人们健康的疾病之一，每天有数亿人承受COPD带来的痛苦和危害，其全球发病率、病死率及致残率均较高，在中国以北方农村地区尤为严重，既往对北方农村地区COPD死亡及过早死亡的综合报道较少。目的　分析辽宁省农村地区2009—2016年COPD死亡及过早死亡变化趋势，并进行有效预测，为COPD防控提供科学依据。方法　收集2009—2016年辽宁省彰武县疾病预防控制中心、凤城市疾病预防控制中心的死亡数据和彰武县、凤城市公安部门的人口数据，计算COPD死亡率、标化死亡率、总死亡率、标化总死亡率、过早死亡率、标化过早死亡率、过早死亡概率、总过早死亡率、标化总过早死亡率、总过早死亡概率、年度变化百分比（APC）等指标，应用Joinpoint回归和灰色模型GM（1，1）对COPD死亡率、标化死亡率、总死亡率、标化总死亡率、过早死亡率、标化过早死亡率、过早死亡概率、总过早死亡率、标化总过早死亡率、总过早死亡概率进行趋势分析和预测。结果　辽宁省农村地区2009—2016年COPD死亡人数为1 912人，过早死亡人数为389人（占20.35%），其中女性COPD死亡率、标化死亡率大于男性（P<0.001）；2009—2016年，女性COPD标化死亡率和COPD标化总死亡率均随年份增加呈下降趋势（P<0.05），男性COPD标化过早死亡率、COPD标化总过早死亡率均随年份增加呈下降趋势（P<0.05）。COPD总过早死亡概率从2009年的0.83%降到2016年的0.77%，以2016年为基准，男性COPD过早死亡概率距离2030年控制目标（1.00%）尚有0.58%的下降空间，女性COPD过早死亡概率距离2030年控制目标（1.12%）尚有0.28%的下降空间。GM（1，1）预测结果显示COPD标化总死亡率和总过早死亡率均随年份增加呈下降趋势（P<0.001），各模型的平均绝对百分误差（MAPE）为1.18%~8.76%。结论　辽宁省农村地区2009—2016年COPD死亡率和过早死亡率总体呈下降趋势，但对未来预测显示男性COPD死亡率、过早死亡率、COPD总死亡率随年份的增加呈上升趋势。因此，应采取有针对性的预防措施，减少居民接触危险因素的机会，降低COPD导致的危害。

关键词: 肺疾病, 慢性阻塞性；死亡率；死亡率, 过早；趋势分析；灰色模型