Page 26 - 中国全科医学2022-16期

http://www.chinagp.net E-mail:zgqkyx@chinagp.net.cn ·1943·

theoretical support for the formulation of prevention and control measures. Objective To describe and analyze the burden of
COPD and its temporal trends from 1990 to 2019，and to forecast the COPD burden between 2020 and 2024 in China，provide a
basis for scientific prevention and control of COPD in China. Methods In December 2021，data about indicators measuring the
burden of COPD in China from 1990—2019，including COPD prevalence，mortality and DALYs rates，were extracted from the Global
Burden of Disease 2019. The average annual percentage change was used to measure the temporal trend of COPD prevalence，
mortality and DALYs rates over the period. Autoregressive moving average（ARIMA）and neural network autoregressive
（NNAR）models for COPD prevalence，mortality and DALYs rates were constructed based on data from 1990-2016（training
set），and their predictive performance was tested using data from 2017—2019 （test set）. The relative error，mean absolute
percentage error（MAPE），mean absolute error（MAE）and root mean square error（RMSE） between predicted and actual
values of these two models were calculated for comparing their goodness of fit and predictive performance. And the better model
was used to estimate the COPD disease burden from 2020 to 2024. Results COPD prevalence，mortality and DALYs rates
in China during 1990—2019：（1）The prevalence of COPD in the whole population increased from 2 344.40/100 000 to
3 175.37/100 000，with an average annual growth rate of 1.04%. And the average annual growth rates of COPD prevalence were
0.92% and 1.13% for men and women，respectively.（2）The mortality rate of COPD in the whole population decreased from
105.09/100 000 to 72.94/100 000，with an average annual rate of decrease of 1.29%. And the mortality rates in both men and
women showed a decreasing trend，with average annual rates of decrease of 0.83% and 1.83%，respectively.（3）The rate of
COPD DALYs in the whole Chinese population decreased from 2 206.55/100 000 to 1 400.71 /100 000，with an average annual
rate of decrease of 1.56%. And the rates of DALYs in both men and women showed a decreasing trend，with average annual
rates of decrease of 1.37% and 1.86%，respectively. The predicted values of the trends by both ARIMA and NNAR models
were basically consistent with the actual values of trends，but the ARIMA model had smaller relative error，MAPE，MAE and
RMSE，indicating that it may have better prediction accuracy. And by the ARIMA model，the predicted COPD prevalence
in 2020—2024 was 3 229.77/100 000，3 262.44/100 000，3 292.38/100 000，3 322.31/100 000，and 3 352.25/100 000，
respectively；the predicted mortality rates were 74.50/100 000，75.49/100 000，76.11/100 000，76.50/100 000，and
76.75/100 000，respectively；the predicted DALYs rates were 1 429.56/100 000，1 452.07/100 000，1 469.64/100 000，
1 483.35/100 000，and 1 494.05/100 000，respectively. Conclusion The trend of burden of COPD in China was predicted to be
increased from 2020 to 2024 by the ARIMA model. Owing to the high goodness of fit and predictive accuracy demonstrated in the
prediction，the ARIMA model may be used as a tool for predicting short-term burden of COPD.
【Key words】 Lung diseases，obstructive；Burden of illness；Cost of illness；ARIMA model；NNAR model；Prediction

慢性阻塞性肺疾病（COPD）是一种常见的、可以
本文要点：
预防和治疗的、以呼吸道持续性症状和气流受限为主 （1）1990—2019 年中国全人群慢性阻塞
要特征的慢性病 ［1］ 。COPD 目前居全球死亡原因的第 性肺疾病（COPD）患病率从 2 344.40/10 增至
5
四位，而到 2030 年 COPD 将可能成为全球第三大死亡 3 175.37/10 ，年均增长 1.04%；男性和女性 COPD
5
原因 ［2］ 。我国每年约有 100 万人死于 COPD，并有大 患病 率平 均每 年分 别增 长 0.92% 和 1.13%。（2）
约 500 万人因 COPD 致残 ［3］ 。2015 年，我国≥ 20 岁 5
1990—2019 年中国全人群 COPD 死亡率由 105.09/10
成年人中有 8.6%（9 990 万）的成年人患有 COPD，在 下降至 72.94/10 ，年均降幅为 1.29%；男性和
5
≥ 40 岁人群中 COPD 患病率更是高达 13.7% ［4］ 。随着 女 性 COPD 死 亡 率 平 均 每 年 分 别 下 降 0.83% 和
我国吸烟人数的逐渐增多和人口老龄化程度的不断加 1.83%。（3）1990—2019 年中国全人群 COPD 伤
剧，预计我国 COPD 患病率和疾病负担将会持续上升。 残调整寿命年（DALYs）率从 2 206.55/10 下降至
5
中国 COPD 防控形势严峻，有效预测 COPD 疾病负担 1 400.71/10 ，年均下降 1.56%；男性和女性的 COPD
5
发展趋势可为 COPD 预防和控制策略的制定提供理论 DALYs 率 平 均 每 年 分 别 下 降 1.37% 和 1.86%。
支持 ［5］ 。患病率、死亡率和伤残调整寿命年（DALYs） （4）预测得到 2020—2024 年中国 COPD 患病率
5
5
率是衡量人群疾病负担的重要指标。既往研究多侧重 分别为 3 229.77/10 、3 262.44/10 、3 292.38/10 、
5
5
于对我国 COPD 疾病负担的变化趋势进行描述与分析， 3 322.31/10 、3 352.25/10 ；死亡率分别为 74.50/10 、
5
5
5
5
5
5
较少涉及对 COPD 患病率、死亡率和 DALYs 率未来发 75.49/10 、76.11/10 、76.50/10 、76.75/10 ；DALYs
5
5
5
展趋势的预测 ［6-8］ 。COPD 患病率、死亡率和 DALYs 率分别为 1 429.56/10 、1 452.07/10 、1 469.64/10 、
5
5
率数据呈现一种长期趋势，且具有随机波动的特点， 1 483.35/10 、1 494.05/10 。