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2011－2021年上海市奉贤区慢性阻塞性肺疾病死亡趋势分析

Trends of chronic obstructive pulmonary disease mortality in Fenxian district of Shanghai, 2011−2021

    摘要
  • 摘要:
    目的 了解2011—2021年上海市奉贤区慢性阻塞性肺疾病（COPD）死亡率变化趋势，为制定COPD的防控政策提供基础数据。
    方法 选择 2011—2021 年上海市奉贤区户籍居民死因监测数据，计算COPD的粗死亡率、标化死亡率，通过计算年度变化百分比（APC）和平均年度变化百分比（AAPC）分析标化死亡率与总体变化趋势，应用年龄–时期–队列模型分析不同年龄、时期、出生队列人群的COPD死亡风险。
    结果 2011—2021年上海市奉贤区报告COPD死亡共计4 587例，粗死亡率78.27/10万，标化死亡率46.87/10万，标化死亡率呈下降趋势（AAPC= −8.47%，P<0.001）。 男性的COPD粗死亡率（99.22/10万）、标化死亡率（65.47/10 万）均高于女性（粗死亡率57.79/10万、标化死亡率32.09/10万）（P<0.001）。 COPD死亡风险随着年龄增长而增长，超高龄段老人COPD死亡风险快速上升；2011—2021年全人群和男女性的时期效应系数呈下降趋势，女性在2011—2014年的效应系数（APC= −0.20%, P<0.05）下降快于2014—2021年（APC= −0.10%, P<0.05）；1921—1940出生人群COPD死亡风险显著下降，1940年后出生人群的COPD死亡风险变化无统计学意义（P>0.05），1911—1913年男性出生队列的效应系数显著上升（β=1.93，P<0.05），1926—1943年出男性出生队列死亡风险显著下降（β= −0.23，P<0.05）。
    结论 2011—2021年上海市奉贤区COPD的死亡风险虽然持续下降，但随出生队列推移下降速度放缓，需要通过对目标人群早期筛查、主动干预、健康教育、分类管理等措施以进一步预防COPD的发生、发展，改善患者生存质量。

     

    Abstract:
    Objective  To analyze the mortality trend of chronic obstructive pulmonary disease (COPD) in Shanghai from 2011 to 2021 and provide evidence for development of COPD prevention and control policies .
    Methods The death cause surveillance data and population infirmation of residents in Fengxian district of Shanghai from 2011 to 2021 were collected to calculate the the crude mortality rate and the age-standardized-mortality rate of COPD. The overall trends of standardized mortality rate of COPD were analyzed by calculated annual percentage change (APC) and average annual percentage change (AAPC) . Age-period-cohort model was used to analyze the risk for COPD death in different age groups, periods and birth cohorts.
    Results A total of 4 587 COPD deaths were reported in Fengxian from 2011 to 2021,with a crude mortality rate of 78.27/100 000 and an age standardized mortality rate of 46.87/100 000. The age standardized mortality rate decreased significantly (AAPC= −8.47%, P<0.001).The crude mortality rate and the age standardized mortality rate of COPD were higher in men (99.22/100 000, 65.47/100 000) than in women (57.79/100 000, 32.09/100 000 ) (P<0.001). The risk for COPD death increased with age, and the risk for COPD death increased rapidly in the super-elderly. The risk in whole population showed a decreasing trend in diferent prtiods from 2011 to 2021, and the risk in women decreased more rapidly during 2011−2014 (APC= −0.20%, P<0.05）compared with that during 2014-2021 (APC= −0.10%, P<0.05）. There was a significant decrease in the risk for COPD death among those born from 1921 to 1940 and no significant change in the risk for death was found in those born after 1940. In men, the risk increased significantly in birth cohorts between 1911 and 1913 (β=1.93, P<0.05), and decreased significantly in birth cohort between 1926 and 1943 (β= −0.23, P<0.05).
    Conclusion Although the death risk of COPD in Fengxian continued to decline, the decline rate slowed down with birth cohort year. It is necessary to strengthen the early screening, active intervention, health education, classified managementthe in populations at risk to prevent the incidence and development of COPD and improve the life quality of COPD patients.

     

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