辽宁省农村地区2009—2016年慢性阻塞性肺疾病死亡及过早死亡趋势分析及预测研究
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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。
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.
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.
引文
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[13]罗文婷,林艺兰.厦门市慢性阻塞性肺疾病死亡趋势分析及预测[J].疾病监测与控制,2016,10(10):783-785.LUO W T,LIU Y L.Mortality time trends and projection of chronic obstructive pulmonary disease in Xiamen[J].Journal of Diseases Monitor&Control,2016,10(10):783-785.
[14]CHAN T C,CHIANG P H,SU M D,et al.Geographic disparity in chronic obstructive pulmonary disease(COPD)mortality rates among the taiwan population[J].PLoS One,2014,9(5):e98170.DOI:10.1371/journal.pone.0098170.
[15]Centers for Disease Control and Prevention(CDC).Deaths from chronic obstructive pulmonary disease-United States,2000-2005[J].MMWR Morb Mortal Wkly Rep,2008,57(45):1229-1232.
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[17]SIEGEL R L,WARD E M,JEMAL A.Trends in colorectal cancer incidence rates in the United States by tumor location and stage,1992-2008[J].Cancer Epidemiol Biomarkers Prev,2012,21(3):411-416.DOI:10.1158/1055-9965.EPI-11-1020.
[18]吴想军,李子巍,屈若祎,等.2004-2010年中国消化道恶性肿瘤死亡率趋势分析[J].中国卫生统计,2017,34(1):43-46.WU X J,LI Z W,QU R Y,et al.Analysis of digestive malignant tumor mortality trend from 2004 to 2010 in China[J].Chinese Journal of Health Statistics,2017,34(1):43-46.
[19]于连政,冯毅平,穆慧娟,等.辽宁省1984-2010年城乡居民慢性阻塞性肺疾病死亡率变化趋势分析[J].中华流行病学杂志,2012,33(4):399-403.YU L Z,FENG Y P,MU H J,et al.Mortality trend on chronic obstructive pulmonary disease in Liaoning province,1984-2010[J].Chinese JournaL of Epidemiology,2012,33(4):399-403.
[20]BATURA G H.Systemic features in chronic obstructive pulmonary disease[J].Pneumonol Alergol Pol,2009,77(2):180-185.
[21]GERSHON A S,DOLMAGE T E,STEPHENSON A,et al.Chronic obstructive pulmonary disease and socioeconomic status:a systematic review[J].COPD,2012,9(3):216-226.DOI:10.3109/15412555.2011.648030.
[22]曾新颖,李镒冲,刘世炜,等.1990-2015年中国四类慢性病早死概率与“健康中国2030”下降目标分析[J].中华预防医学杂志,2017,51(3):209-214.ZENG X Y,LI Y C,LIU S W,et al.Subnational analysis of probability of premature mortality caused by four main noncommunicable diseases in China during 1990-2015 and“Health China 2030”reduction target[J].Chinese Journal of Preventive Medicine,2017,51(3):209-214.
[23]丁贤彬,焦艳,毛德强,等.2010-2016年重庆市慢性呼吸系统疾病早死概率及潜在寿命损失变化趋势分析[J].现代预防医学,2018,45(1):19-23.DING X B,JIAO Y,MAO D Q,et al.Probability of premature death and potential year of life loss caused by chronic respiratory disease in Chongqing,2010-2016[J].Modern Preventive Medicine,2018,45(1):19-23.
[24]RAN P X,WANG C,YAO W Z,et al.The risk factors for chronic obstructive pulmonary disease in females in Chinese rural areas[J].Zhonghua Nei Ke Za Zhi,2006,45(12):974-979.
[25]刘朝,肖丹,王辰.戒烟是慢性阻塞性肺疾病防治的最有效措施[J].中华结核和呼吸杂志,2017,40(12):894-897.DOI:10.3760/cma.j.issn.1001-0939.2017.12.005.LIU Z,XIAO D,WANG C.Smoking cessation is the most effective measure to prevent and treat chronic obstructive pulmonary disease[J].Chinese Journal of Tuberculosis and Respiratory Diseases,2017,40(12):894-897.DOI:10.3760/cma.j.issn.1001-0939.2017.12.005.
[26]张亮,林庆山,白玉琢,等.铁岭市2007-2015年城市居民食管癌死亡变化情况Joinpoint分析及灰色模型预测析[J].中华肿瘤防治杂志,2016,23(23):1531-1534.DOI:10.16073/j.cnki.cjcpt.2016.23.002.ZHANG L,LIN Q S,BAI Y Z,et al.Analyze the change of mortality of esophagus cancer in Tieling district from 2007 to 2015and predict with GM model[J].Chinese Journal of Cancer Prevention and Treatment,2016,23(23):1531-1534.DOI:10.16073/j.cnki.cjcpt.2016.23.002.
[27]邵珠艳,王春梅,魏曼莎.灰色GM(1,1)预测模型在疾病预测中的应用[J].中国医院统计,2003,10(3):146-148.DOI:10.3969/j.issn.1006-5253.2003.03.005.SHAO Z Y,WANG C M,WEI M S.Application of the grey system gm(1,1)forecast model on predictive diseases[J].Chinese Journal of Hospital Statistics,2003,10(3):146-148.DOI:10.3969/j.issn.1006-5253.2003.03.005.
[28]United Nations Department of Economic and Social Affairs.Population ageing and development 2012[M].New York:United Nations Department of Economic and Social Affairs,2013:1-2.
[29]MANNINO D M,BUIST A S.Global burden of COPD:risk factors,prevalence,and future trends[J].Lancet,2007,370:765-773.DOI:10.1016/S0140-6736(07)61380-4.
[2]MURRAY C J,LOPEZ A D.Alternative projections of mortality and disability by cause 1990-2020:Global Burden of Disease Study[J].Lancet,1997,349(9064):1498-1504.DOI:10.1016/S0140-6736(96)07492-2.
[3]REILLY K H,GU D,DUAN X,et al.Risk factors for chronic obstructive pulmonary disease mortality in Chinese adults[J].Am J Epidemiol,2008,167(8):998-1004.DOI:10.1093/aje/kwm393.
[4]World Health Organization.International Statistical Classification of Diseases and Related Health Problems 10th Revision(ICD-10)[EB/OL].(2016-1-28)[2018-06-16].http://apps.who.int/classifications/icd10/browse/2016/en#/J40-J47.
[5]国家卫生和计划生育委员会.中国卫生和计划生育统计年鉴2013[M].北京:中国协和医科大学出版社,2013.
[6]WHO.Global status report on noncommunicable diseases2014[M].Geneva:World Health Organization,2014.
[7]新华社.“健康中国2030”规划纲要[EB/OL].(2016-10-25)[2018-06-16].http://www.xinhuanet.com/health/2016-10/25/c-1119786029.htm.
[8]KIM H J,FAY M P,FEUER E J,et al.Permutation tests for joinpoint regression with applications to cancer rates[J].Stat Med,2000,19(3):335-351.
[9]CLEGG L X,HANKEY B F,TIWARI R,et al.Estimating average annual percent change in trend analysis[J].Stat Med,2009,28(29):3670-3682.DOI:10.1002/sim.3733.
[10]邓聚龙.灰色系统[M].北京:国防工业出版社,1985:1-5.
[11]朱登远,常晓凤.灰色预测GM(1,1)模型的Matlab实现[J].河南城建学院学报,2013,22(3):40-46.DOI:10.14140/j.cnki.hncjxb.2013.03.020.ZHU D Y,CHANG X F.Matlab realization of grey prediction GM(1,1)model[J].Journal of Henan University of Urban Construction,2013,22(3):40-46.DOI:10.14140/j.cnki.hncjxb.2013.03.020.
[12]FERKOL T,SCHRAUFNAGEL D.The global burden of respiratory disease[J].Ann Am Thorac Soc,2014,11(3):404-406.DOI:10.1513/AnnalsATS.201311-405PS.
[13]罗文婷,林艺兰.厦门市慢性阻塞性肺疾病死亡趋势分析及预测[J].疾病监测与控制,2016,10(10):783-785.LUO W T,LIU Y L.Mortality time trends and projection of chronic obstructive pulmonary disease in Xiamen[J].Journal of Diseases Monitor&Control,2016,10(10):783-785.
[14]CHAN T C,CHIANG P H,SU M D,et al.Geographic disparity in chronic obstructive pulmonary disease(COPD)mortality rates among the taiwan population[J].PLoS One,2014,9(5):e98170.DOI:10.1371/journal.pone.0098170.
[15]Centers for Disease Control and Prevention(CDC).Deaths from chronic obstructive pulmonary disease-United States,2000-2005[J].MMWR Morb Mortal Wkly Rep,2008,57(45):1229-1232.
[16]MANNINO D M,KIRIZ V A.Changing the burden of COPDmortality[J].Int J Chron Obstruct Pulmon Dis,2006,1(3):219-233.
[17]SIEGEL R L,WARD E M,JEMAL A.Trends in colorectal cancer incidence rates in the United States by tumor location and stage,1992-2008[J].Cancer Epidemiol Biomarkers Prev,2012,21(3):411-416.DOI:10.1158/1055-9965.EPI-11-1020.
[18]吴想军,李子巍,屈若祎,等.2004-2010年中国消化道恶性肿瘤死亡率趋势分析[J].中国卫生统计,2017,34(1):43-46.WU X J,LI Z W,QU R Y,et al.Analysis of digestive malignant tumor mortality trend from 2004 to 2010 in China[J].Chinese Journal of Health Statistics,2017,34(1):43-46.
[19]于连政,冯毅平,穆慧娟,等.辽宁省1984-2010年城乡居民慢性阻塞性肺疾病死亡率变化趋势分析[J].中华流行病学杂志,2012,33(4):399-403.YU L Z,FENG Y P,MU H J,et al.Mortality trend on chronic obstructive pulmonary disease in Liaoning province,1984-2010[J].Chinese JournaL of Epidemiology,2012,33(4):399-403.
[20]BATURA G H.Systemic features in chronic obstructive pulmonary disease[J].Pneumonol Alergol Pol,2009,77(2):180-185.
[21]GERSHON A S,DOLMAGE T E,STEPHENSON A,et al.Chronic obstructive pulmonary disease and socioeconomic status:a systematic review[J].COPD,2012,9(3):216-226.DOI:10.3109/15412555.2011.648030.
[22]曾新颖,李镒冲,刘世炜,等.1990-2015年中国四类慢性病早死概率与“健康中国2030”下降目标分析[J].中华预防医学杂志,2017,51(3):209-214.ZENG X Y,LI Y C,LIU S W,et al.Subnational analysis of probability of premature mortality caused by four main noncommunicable diseases in China during 1990-2015 and“Health China 2030”reduction target[J].Chinese Journal of Preventive Medicine,2017,51(3):209-214.
[23]丁贤彬,焦艳,毛德强,等.2010-2016年重庆市慢性呼吸系统疾病早死概率及潜在寿命损失变化趋势分析[J].现代预防医学,2018,45(1):19-23.DING X B,JIAO Y,MAO D Q,et al.Probability of premature death and potential year of life loss caused by chronic respiratory disease in Chongqing,2010-2016[J].Modern Preventive Medicine,2018,45(1):19-23.
[24]RAN P X,WANG C,YAO W Z,et al.The risk factors for chronic obstructive pulmonary disease in females in Chinese rural areas[J].Zhonghua Nei Ke Za Zhi,2006,45(12):974-979.
[25]刘朝,肖丹,王辰.戒烟是慢性阻塞性肺疾病防治的最有效措施[J].中华结核和呼吸杂志,2017,40(12):894-897.DOI:10.3760/cma.j.issn.1001-0939.2017.12.005.LIU Z,XIAO D,WANG C.Smoking cessation is the most effective measure to prevent and treat chronic obstructive pulmonary disease[J].Chinese Journal of Tuberculosis and Respiratory Diseases,2017,40(12):894-897.DOI:10.3760/cma.j.issn.1001-0939.2017.12.005.
[26]张亮,林庆山,白玉琢,等.铁岭市2007-2015年城市居民食管癌死亡变化情况Joinpoint分析及灰色模型预测析[J].中华肿瘤防治杂志,2016,23(23):1531-1534.DOI:10.16073/j.cnki.cjcpt.2016.23.002.ZHANG L,LIN Q S,BAI Y Z,et al.Analyze the change of mortality of esophagus cancer in Tieling district from 2007 to 2015and predict with GM model[J].Chinese Journal of Cancer Prevention and Treatment,2016,23(23):1531-1534.DOI:10.16073/j.cnki.cjcpt.2016.23.002.
[27]邵珠艳,王春梅,魏曼莎.灰色GM(1,1)预测模型在疾病预测中的应用[J].中国医院统计,2003,10(3):146-148.DOI:10.3969/j.issn.1006-5253.2003.03.005.SHAO Z Y,WANG C M,WEI M S.Application of the grey system gm(1,1)forecast model on predictive diseases[J].Chinese Journal of Hospital Statistics,2003,10(3):146-148.DOI:10.3969/j.issn.1006-5253.2003.03.005.
[28]United Nations Department of Economic and Social Affairs.Population ageing and development 2012[M].New York:United Nations Department of Economic and Social Affairs,2013:1-2.
[29]MANNINO D M,BUIST A S.Global burden of COPD:risk factors,prevalence,and future trends[J].Lancet,2007,370:765-773.DOI:10.1016/S0140-6736(07)61380-4.
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