关键词: 肺疾病, 慢性阻塞性；死亡率；死亡率, 过早；趋势分析；灰色模型

Abstract: Background　Chronic obstructive pulmonary disease （COPD） is one of the most severe diseases affecting people's health in the world.Hundreds of millions of people suffer from the pain and harm caused by COPD every day.In the background of high incidence，mortality and disability rate around the globe，COPD mainly affects rural areas in the north of China，but there are few comprehensive reports of COPD death and premature death in these areas.Objective　To analyze the trend of death and premature death caused by COPD in rural areas of Liaoning Province from 2009 to 2016，and make effective prediction，so as to provide a scientific basis for COPD prevention and control.Methods　The death data of Zhangwu Center for Disease Control and Prevention and Fengcheng Center for Disease Control and Prevention from 2009 to 2016 and the population data of Zhangwu County and Fengcheng City from public security departments were collected.The mortality rate，standardized mortality rate，total mortality rate，standardized total mortality rate，premature mortality rate，standardized premature mortality rate，premature death probability，total premature mortality rate，standardized total premature mortality rate，total premature death probability and the annual percentage change（APC）were calculated.COPD mortality rate，standardized mortality rate，total mortality rate，standardized total mortality rate，premature mortality rate，standardized premature mortality rate，premature death probability，total premature mortality rate，standardized total premature mortality rate，total premature death probability were analyzed and predicted by using Joinpoint regression and grey model GM（1，1）．Results　 In rural areas of Liaoning Province from 2009 to 2016，the number of deaths from COPD was 1 912，and the number of premature deaths was 389，accounting for 20.35% of deaths from COPD.The mortality and standardized mortality rates of COPD were significantly higher in females than those in males（P<0.001）．From 2009 to 2016，the standardized mortality rate and the standardized total mortality rate in females decreased by year（P<0.05） and premature mortality and standardized total premature mortality in males showed a downward trend by year（P<0.05）．The total premature death probability of COPD decreased from 0.83% in 2009 to 0.77% in 2016.There was a gap of 0.58% between the data of 2016 and the control target of 2030（1.00%）in terms of the probability of premature death in men，and the probability of premature death in women is 0.28% higher than the control target of 2030（1.12%）．The results of GM（1，1） prediction showed that the total mortality of COPD and the total premature mortality of COPD decreased by year（P<0.001）．The MAPE of each model was from 1.18% to 8.76%.Conclusion　In the rural areas of Liaoning Province，the mortality and premature mortality of COPD decreased from 2009 to 2016，but future predictions showed that the mortality and premature mortality rate in men and the total mortality of COPD increased by year.Therefore，targeted preventions should be taken to reduce residents' exposure to risk factors and reduce the harm caused by COPD.

Key words: Pulmonary disease, chronic obstructive；Mortality；Mortality, premature；Trend analysis；Grey models