[Disease burden of chronic obstructive pulmonary diseases in China from 1990 to 2019].

Objective: To examine the trend of the burden on chronic obstructive pulmonary diseases (COPD) and epidemiologic transition on related risk factors among the Chinese population from 1990 to 2019. Methods: Based on the data from the Global Burden of Disease 2019 Study, we used the indicator numbers such as disability-adjusted life year (DALY), years of life lost (YLD), years lived with disability (YLL), and prevalence rate to describe the changes of COPD burden stratified by different sex and age groups from 1990 to 2019. We applied population attribution faction (PAF) to analyze the burden attributed to risk factors and epidemiological transition. Results: In 2019, the age-standard rate for DALY, YLD, and YLL and prevalence rate for COPD were 1 102.77/100 000 population,862.37/100 000 population, 240.40/100 000 population, and 2 404.41/100 000. Both age-standardized DALY and YLL rates for COPD in males were higher than in females, except for the YLD rate in females. COPD's top five risk factors were particulate matter pollution, smoking, occupational particulate matter, gases, and fumes, low temperature, and secondhand smoke. Smoking surpassed environmental particulate pollution in 1994 and became the first factor causing the disease burden of COPD. Since then, the order of risk factors has not changed. The PAF of environmental particulate pollutants increased by 1.78% annually, from 15.22% in 1990 to 25.37%, and the PAF of household air pollution from solid fuels decreased by 5.59% annually, from 40.30% in 1990 to 7.59%. Conclusions: From 1990 to 2019, the per person health loss caused by COPD in China showed an overall downward trend. The PAF of relevant risk factors has also changed, the importance of environmental factors is relatively declined, and the status of smoking and other related risk behaviors has become increasingly prominent. The prevention and control of COPD can focus on screening high-risk groups (≥40 years old, smoking, heavy air pollution, having occupational exposure), smoking cessation, and environmental treatment.目的： 探讨1990-2019年中国慢性阻塞性肺疾病（COPD）疾病负担及其危险因素的变化趋势。 方法： 基于2019年全球疾病负担中国研究数据，利用伤残调整寿命年（DALY）、伤残损失寿命年（YLD）、早死损失寿命年（YLL）和患病水平等指标对不同性别和年龄人群1990-2019年的疾病负担变化趋势进行描述，并结合人群归因分值（PAF）分析COPD危险因素的变化情况。 结果： 2019年我国年龄COPD标化DALY率、标化YLL率、标化YLD率分别为1 102.77人年/10万、862.37人年/10万和240.40人年/10万，标化患病率为2 404.41/10万。男性标化DALY率和标化YLL率高于女性，女性标化YLD率和标化患病率高于男性。COPD排名前5位的危险因素为吸烟、颗粒物污染、职业粉尘和有害气体、低温和二手烟。吸烟在1994年超越颗粒物污染，成为造成COPD疾病负担的首位因素，此后各危险因素的次序未发生变化。环境颗粒物污染的PAF年均上升1.78%，从1990年的15.22%上升至25.37%；固体燃料致室内空气污染年均下降5.59%，从1990年的40.30%下降至7.59%。 结论： 1990-2019年，COPD对我国人群造成的人均健康损失总体呈下降趋势，但老龄化使人群的COPD疾病负担仍处于较高水平。COPD相关危险因素的PAF发生了变化，环境因素的重要性相对下降，吸烟等相关危险行为的地位日益突出。COPD防治重点可侧重于高危人群（≥40岁、吸烟、空气污染重、有职业暴露）筛查、戒烟教育以及环境治理。.