[Prediction on the burden of disease of chronic obstructive pulmonary disease and simulation of the effectiveness of controlling risk factors in China by 2030].

Objective: To forecast the burden of chronic obstructive pulmonary disease (COPD) in China by 2030 and evaluate the effectiveness of controlling risk factors based on the predictive model. Methods: Based on the relationship between the death of COPD and exposure to risk factors and the theory of comparative risk assessment, we used the estimates of the Global Burden of Disease Study 2015 (GBD2015) for China, targets for controlling risk factors, and proportion change model to project the number of deaths, standardized mortality rate, and probability of premature mortality from chronic respiratory diseases by 2030 in different scenarios and to evaluate the impact of controlling the included risk factors to the disease burden of COPD in 2030. Results: If the trends in exposure to risk factors from 1990 to 2015 continued, the number of deaths and the mortality for COPD would be 1.06 million and 73.85 per 100 000 population in China by 2030, respectively, with an increase of 15.81% and 10.69% compared to those in 2015. Compared to 2015, the age-standardized mortality rate would decrease by 38.88%, and the premature mortality would reduce by 52.73% by 2030. If the smoking rate and fine particulate matter (PM2.5) concentration separately achieve their control targets by 2030, there would be 0.34 and 0.27 million deaths that could be avoided compared to the predicted numbers based on the natural trends in exposure to risk factors and the probability of premature death would reduce to 0.59% and 0.52%, respectively. If the control targets of all included risk factors were achieved by 2030, a total of 0.53 million deaths would be averted, and the probability of premature death would decrease to 0.44%. Conclusions: If the exposures to risk factors continued as showed from 1990 to 2015, the number of deaths and mortality for COPD would increase by 2030 compared to 2015, and the standardized mortality and the probability of premature death would decrease significantly, which would achieve the targets of preventing and controlling COPD. If the exposure to the included risk factors all achieved the targets by 2030, the burden of COPD would be reduced, suggesting that the control of tobacco use and air pollution should be enhanced to prevent and control COPD.目的： 基于统计模型预测2030年中国慢性阻塞性肺疾病（COPD）的疾病负担，评估控制危险因素对降低疾病负担的效果。 方法： 基于死亡风险与危险因素暴露的相关性和比较风险评估理论，利用2015年全球疾病负担研究的中国数据，筛选危险因素，采用比例变化模型估计2030年不同场景下COPD死亡情况，模拟控制危险因素对2030年COPD的疾病负担的影响。 结果： 如危险因素暴露按1990-2015年的变化趋势发展，2030年中国COPD的死亡例数为105.54万例、死亡率为73.85/10万，相比2015年将分别上升15.81%和10.69%，标化死亡率和过早死亡概率将降低38.88%和52.73%。如吸烟或PM2.5污染控制达标，到2030年相比于自然趋势发展可分别减少34.07万和27.34万死亡例数，过早死亡概率将降至0.59%和0.52%。如所有危险因素控制达标，到2030年我国可避免52.59万例死亡，过早死亡概率将降至0.44%。 结论： 自然趋势下，2030年COPD死亡数和死亡率预计将比2015年高，但标化死亡率与过早死亡概率将下降。如所有危险因素控制达标，可进一步降低COPD的负担，提示应加强控烟与大气污染治理等举措来降低COPD的疾病负担。.