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

Mortality trend on chronic obstructive pulmonary disease in Liaoning province, 1984-2010

目的分析辽宁省城乡居民1984--2010年慢性阻塞性肺疾病（COPD）死亡变化趋势。方法利用JoinpointRegressionProgram软件对数线性泊松回归模型产生的MonteCarlo组合检验确定趋势线拐点，分析拐点前后COPD死亡率的年均变化率及总体变化趋势。结果辽宁省城市居民1984--2010年和农村居民1999--2009年COPD死亡率均呈显著下降趋势。城市居民COPD中国人口标化死亡率从1984年的243．93／10万下降为2010年的33．13／10万，年均下降5．8％。农村居民COPD中国人口标化死亡率从1999年的251．33／10万单调下降至2009年的102．25／10万，年均下降6．8％。1994—2010年城市居民COPD死亡率均下降9．0％，超过农村居民1999--2009年年均下降水平（6．8％）。支气管炎死亡率的下降是导致COPD总体死亡率下降的主要原因。COPD死亡率总体水平城市低于农村，城市男性高于城市女性，农村女性高于农村男性。结论辽宁省1984--2010年COPD死亡率呈显著下降趋势。

Objective To evaluate the mortality trend of chronic obstructive pulmonary disease （COPD） among residents in Liaoning province during the period of 1984-2010. Methods The cut-points were ascertained by Monte Carlo Permutation test in COPD mortality trend lines of Poisson regression with Joinpoint Regression Program. The annual percent changes （APC） before and after the cut-points and the average annual percent change（AAPC） of COPD mortality were examined during the period. Results Significant declining trends on COPD mortality among the urban population during 1984-2010 and that of rural population during 1999-2009 were found. The standardized urban COPD mortality rate by Chinese population declined from 243.93 per 100 thousand in 1984 to 33.13 per 100 thousand in 2010. The urban 26 years AAPC was -5.8%. While the mortality in the rural population decreased from 251.33 per 100 thousand in 1999 to 102.25 per 100 thousand in 2009 in the same population. The rural 10 years＇ AAPC was -6.8%. The total trend of COPD mortality reduction was mainly resulted from the fast decline of bronchitis mortality. The AAPC of COPD mortality of the urban population was-9.0% and greater than that of the rural population （-6.8%） from 1999 to 2009. The urban population had a lower COPD mortality than that of the rural population. In urban area, males had a higher COPD mortality than females, however, in the rural area, males had a lower COPD mortality than the females. Conclusion The COPD mortality among the residents of Liaoning province declined significantly from 1984 to 2010. Further studies are needed to confirm the viewpoint of WHO that the prevalence of COPD would have a continuous increasing trend in China.