COPD 在老年患者(特别是 65 岁及以上人群)中更常见。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%。[9]Varmaghani M, Dehghani M, Heidari E, et al. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019 Mar 19;25(1):47-57.
https://www.doi.org/10.26719/emhj.18.014
http://www.ncbi.nlm.nih.gov/pubmed/30919925?tool=bestpractice.com
在美国,COPD 的患病率估计值为 14%。[10]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;14:103.
https://www.doi.org/10.1186/1465-9921-14-103
http://www.ncbi.nlm.nih.gov/pubmed/24107140?tool=bestpractice.com
一项 2019 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%。[11]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, 2019. MMWR Morb Mortal Wkly Rep. 2021 Jul 2;70(26):959.
https://www.doi.org/10.15585/mmwr.mm7026a3
http://www.ncbi.nlm.nih.gov/pubmed/34197360?tool=bestpractice.com
无论城市化水平如何,COPD 患病率都会随年龄增长而增加。
从 1990 年到 2017 年,全球 COPD 死亡人数增加了 23%,目前每年约有 300 万人死于 COPD。[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. 2020 Feb 19;368:m234.
https://www.doi.org/10.1136/bmj.m234
http://www.ncbi.nlm.nih.gov/pubmed/32075787?tool=bestpractice.com
吸烟和世界人口老龄化的蔓延,以及心血管疾病等其他死因死亡率的下降,意味着到 2060 年,每年可能有超过 540 万人死于 COPD 和相关疾病。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [internet publication].
https://goldcopd.org/2023-gold-report-2
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. 2020 Feb 19;368:m234.
https://www.doi.org/10.1136/bmj.m234
http://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。[13]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;9:597-611.
https://www.doi.org/10.2147/COPD.S61854
http://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。[14]Han MK. Chronic obstructive pulmonary disease in women: a biologically focused review with a systematic search strategy. Int J Chron Obstruct Pulmon Dis. 2020;15:711-21.
https://www.doi.org/10.2147/COPD.S237228
http://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%。[15]Lamprecht B, McBurnie MA, Vollmer WM, et al. COPD in never smokers: results from the population-based burden of obstructive lung disease study. Chest. 2011 Apr;139(4):752-63.
https://www.doi.org/10.1378/chest.10-1253
http://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。[16]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. 2019 Apr 5;68(13):303-7.
https://www.doi.org/10.15585/mmwr.mm6813a2
http://www.ncbi.nlm.nih.gov/pubmed/30946736?tool=bestpractice.com
[17]Syamlal G, Kurth LM, Dodd KE, et al. Chronic obstructive pulmonary disease mortality by industry and occupation: United States, 2020. MMWR Morb Mortal Wkly Rep. 2022 Dec 9;71(49):1550-4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762896
http://www.ncbi.nlm.nih.gov/pubmed/36480469?tool=bestpractice.com