The global burden of chronic respiratory disease in adults
The global burden of chronic respiratory disease in adults
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DOI：
10.5588/ijtld.14.0446
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发表时间：
2015-01-01
影响因子：
4
通讯作者：
Perez-Padilla, R.
中科院分区：
文献类型：
--
作者：
Burney, P.;Jarvis, D.;Perez-Padilla, R.
随着全球人口老龄化，慢性呼吸道疾病正在成为死亡和残疾的一个更加突出的原因。慢性阻塞性肺疾病（COPD）的标准化死亡率在世界低收入地区最高，特别是南亚和撒哈拉以南非洲，尽管气流阻塞在这些地区相对罕见。相比之下，气流阻塞在吸烟率高的地区更为常见。COPD死亡率与用力肺活量低的患病率密切相关，而用力肺活量低又与贫困相关。哮喘的死亡率低于慢性阻塞性肺病的死亡率，但在较贫困地区也相对更常见，特别是大洋洲、南亚和东南亚、中东和非洲。这再次与成人哮喘患病率形成鲜明对比，后者在高收入地区最高。在高收入地区，由于哮喘主要是一个成人问题，近几十年来随着新的治疗指南的传播，强调使用吸入性类固醇来控制疾病，哮喘的死亡率大幅下降。虽然死亡率一直在下降，但在西欧，特应性的患病率在代际之间一直在增加。成年人喘息患病率的变化更多样化，可能受到吸烟减少和吸入性类固醇使用增加的影响。
With an aging global population, chronic respiratory diseases are becoming a more prominent cause of death and disability. Age-standardised death rates from chronic obstructive pulmonary disease (COPD) are highest in low-income regions of the world, particularly South Asia and sub-Saharan Africa, although airflow obstruction is relatively uncommon in these areas. Airflow obstruction is, by contrast, more common in regions with a high prevalence of cigarette smoking. COPD mortality is much more closely related to the prevalence of a low forced vital capacity which is, in turn, associated with poverty. Mortality from asthma is less common than mortality from COPD, but it is also relatively more common in poorer areas, particularly Oceania, South and South-East Asia, the Middle East and Africa. Again this contrasts with the asthma prevalence among adults, which is highest in high-income regions. In high-income areas, mortality due to asthma, which is predominantly an adult problem, has fallen substantially in recent decades with the spread of new guidelines for treatment that emphasise the use of inhaled steroids to control the disease. Although mortality rates have been falling, the prevalence of atopy has been increasing between generations in Western Europe. Changes in the prevalence of wheeze among adults has been more varied and may have been influenced by the reduction in smoking and the increase in the use of inhaled steroids.