慢阻肺在老年患者,特别是 65 岁以上人群中更常见。阻塞性肺疾病负担研究 (BOLD) 倡议估计全球 II 级或以上的慢阻肺总体患病率为 10.1%±4.8% 或更高,其中男性 11.8%±7.9%,女性 8.5%±5.8%。[5]Buist AS, Vollmer WM, McBurnie MA. Worldwide burden of COPD in high- and low-income countries. Part I. The burden of obstructive lung disease (BOLD) initiative. Int J Tuberc Lung Dis. 2008 Jul;12(7):703-8.http://www.ncbi.nlm.nih.gov/pubmed/18544191?tool=bestpractice.com 在女性中,与该病相关的死亡率在过去的 20 年中升高了一倍以上,现与男性死亡率相当。美国慢阻肺病例数自 1982 年以来增加了 41%,累及 1%-3% 的白人女性和 4%-6% 的白人男性。据估计,到 2020 年,COPD 将成为全球第三大死亡原因。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2018 [internet publication].https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf[6]World Health Organization. Chronic obstructive pulmonary disease (COPD). 2018 [internet publication].http://www.who.int/respiratory/copd/en/ 这是因为吸烟人数不断增多、全球人口老龄化以及其他原因(例如心血管疾病)的死亡率下降。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2018 [internet publication].https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf[7]Ford ES, Croft JB, Mannino DM, et al. COPD surveillance - United States, 1999-2011. Chest. 2013 Jul;144(1):284-305.https://journal.chestnet.org/article/S0012-3692(13)60478-X/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/23619732?tool=bestpractice.com 一项系统评价和 meta 分析表明,在 COPD 患者成年子女中,COPD 的患病率高于基于人群的估计值。[8]Li LS, Paquet C, Johnston K, et al. "What are my chances of developing COPD if one of my parents has the disease?" A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring. Int J Chron Obstruct Pulmon Dis. 2017 Jan 24;12:403-15.https://www.dovepress.com/ldquowhat-are-my-chances-of-developing-copd-if-one-of-my-parents-has-t-peer-reviewed-fulltext-article-COPDhttp://www.ncbi.nlm.nih.gov/pubmed/28182144?tool=bestpractice.com 据 1990-1997 年英国一项回顾性研究估计,慢阻肺的男性患病率为 2%,女性患病率为 1%。[9]Soriano JB, Maier WC, Egger P, et al. Recent trends in physician diagnosed COPD in women and men in the UK. Thorax. 2000 Sep;55(9):789-94.http://www.ncbi.nlm.nih.gov/pubmed/10950900?tool=bestpractice.com