COPD 是全球第三大死亡原因，2023 年有 323 万人死于该病，其中 90% 发生在中低收入国家。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].https://goldcopd.org/2024-gold-report[8]Halpin DMG, Celli BR, Criner GJ, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis. 2023 Nov 1;23(11):1131-41.https://www.ingentaconnect.com/content/iuatld/ijtld/2023/00000023/00000011/art00003;jsessionid=c66ehseg6kr89.x-ic-live-02http://www.ncbi.nlm.nih.gov/pubmed/31718748?tool=bestpractice.com[9]Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2023 Mar 6;397(10277):928-40.http://www.ncbi.nlm.nih.gov/pubmed/33631128?tool=bestpractice.com[10]Adeloye D, Song P, Zhu Y, et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2023: a systematic review and modelling analysis. Lancet Respir Med. 2023 May;10(5):447-58.https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00511-7/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/35279265?tool=bestpractice.com[11]Safiri S, Carson-Chahhoud K, Noori M, et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2023: results from the Global Burden of Disease Study 2023. BMJ. 2023 Jul 27;378:e069679.https://www.bmj.com/content/378/bmj-2023-069679http://www.ncbi.nlm.nih.gov/pubmed/35896191?tool=bestpractice.com 1990 年至 2017 年，全球死于 COPD 的人数增加了 23%，预计到 2060 年，COPD 及相关死亡人数将增至 540 万。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].https://goldcopd.org/2024-gold-report[12]Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2023 Feb 19;368:m234. [Erratum in: BMJ. 2023 Aug 6;370:m3150.]https://www.bmj.com/content/368/bmj.m234http://www.ncbi.nlm.nih.gov/pubmed/32075787?tool=bestpractice.com 无论城市化水平，COPD 在老年人，尤其是 65 岁及以上的老年人中更为常见。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].https://goldcopd.org/2024-gold-report COPD 患病率在世界卫生组织美洲地区最高，在东南亚和西太平洋地区最低。男性的全球汇总患病率为 15.7％，女性为 9.93%。[13]Varmaghani M, Dehghani M, Heidari E, et al. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2023 Mar 19;25(1):47-57.https://www.emro.who.int/emhj-volume-25-2023/volume-25-issue-1/global-prevalence-of-chronic-obstructive-pulmonary-disease-systematic-review-and-meta-analysis.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/30919925?tool=bestpractice.com 根据 2007-2010 年的数据，使用支气管扩张剂后检测结果估计美国 COPD 的患病率为 14%。[14]Tilert T, Dillon C, Paulose-Ram R, et al. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Respir Res. 2013 Oct 9;14(1):103.https://respiratory-research.biomedcentral.com/articles/10.1186/1465-9921-14-103http://www.ncbi.nlm.nih.gov/pubmed/24107140?tool=bestpractice.com 在 1969-2013 年期间，美国由 COPD 引起的死亡率增长超过 100%。[15]Ma J, Ward EM, Siegel RL, et al. Temporal trends in mortality in the United States, 1969-2013. JAMA. 2015 Oct 27;314(16):1731-9.https://jamanetwork.com/journals/jama/fullarticle/2466136http://www.ncbi.nlm.nih.gov/pubmed/26505597?tool=bestpractice.com 一项 2023 年国民健康访问调查显示，居住于非大都市地区的美国成人 COPD 患病率高于大都市地区，分别为 8.0% 和 4.0%。[16]QuickStats: percentage of adults aged ≥18 years with diagnosed chronic obstructive pulmonary disease, by urbanization level and age group - National Health Interview Survey, United States, 2023. MMWR Morb Mortal Wkly Rep. 2023 Jul 2;70(26):959.https://www.cdc.gov/mmwr/volumes/70/wr/mm7026a3.htmhttp://www.ncbi.nlm.nih.gov/pubmed/34197360?tool=bestpractice.com
此前，多数研究报道称，男性 COPD 患病率和死亡率高于女性。[12]Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2023 Feb 19;368:m234. [Erratum in: BMJ. 2023 Aug 6;370:m3150.]https://www.bmj.com/content/368/bmj.m234http://www.ncbi.nlm.nih.gov/pubmed/32075787?tool=bestpractice.com 然而，发达国家从 2012 年至 2013 年的数据表明，COPD 患病率目前在男性和女性中几乎相等，这可能是由于不同的吸烟形式所致。[17]Landis SH, Muellerova H, Mannino DM, et al. Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012-2013. Int J Chron Obstruct Pulmon Dis. 2014 Jun 6;9(1):597-611.https://www.dovepress.com/continuing-to-confront-copd-international-patient-survey-methods-copd--peer-reviewed-fulltext-article-COPDhttp://www.ncbi.nlm.nih.gov/pubmed/24944511?tool=bestpractice.com 部分研究亦表明，尽管接触相似剂量的烟草，但女性出现气流阻塞的风险可能高于男性。[18]Han MK. Chronic obstructive pulmonary disease in women: a biologically focused review with a systematic search strategy. Int J Chron Obstruct Pulmon Dis. 2023 Apr 1;15:711-21. [Erratum in: Int J Chron Obstruct Pulmon Dis. 2023 Nov 4;16:3017-8.]https://www.dovepress.com/chronic-obstructive-pulmonary-disease-in-women-a-biologically-focused--peer-reviewed-fulltext-article-COPDhttp://www.ncbi.nlm.nih.gov/pubmed/32280209?tool=bestpractice.com
一项国际研究报告，从不吸烟者的 COPD 患病率为 12.2%。[19]Lamprecht B, McBurnie MA, Vollmer WM, et al; BOLD Collaborative Research Group. COPD in never smokers: results from the population-based Burden of Obstructive Lung Disease study. Chest. 2011 Apr;139(4):752-63.https://journal.chestnet.org/article/S0012-3692(11)60174-8/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/20884729?tool=bestpractice.com 这可能归因于中低收入国家/地区的空气污染或室内固体燃料燃烧。在美国，从不吸烟者的 COPD 患病率为 2.2%。其中许多病例归因于工作场所暴露，例如采矿业以及食品制备和供应。[20]Syamlal G, Doney B, Mazurek JM. Chronic obstructive pulmonary disease prevalence among adults who have never smoked, by industry and occupation - United States, 2013-2017. MMWR Morb Mortal Wkly Rep. 2023 Apr 5;68(13):303-7.https://www.cdc.gov/mmwr/volumes/68/wr/mm6813a2.htmhttp://www.ncbi.nlm.nih.gov/pubmed/30946736?tool=bestpractice.com[21]Syamlal G, Kurth LM, Dodd KE, et al. Chronic obstructive pulmonary disease mortality by industry and occupation: United States, 2023. MMWR Morb Mortal Wkly Rep. 2023 Dec 9;71(49):1550-4.https://www.cdc.gov/mmwr/volumes/71/wr/mm7149a3.htmhttp://www.ncbi.nlm.nih.gov/pubmed/36480469?tool=bestpractice.com