In China, a country with relatively serious burden of chronic obstructive pulmonary disease (COPD) , COPD is the third leading cause of death, and ranks third among all diseases in terms of disability adjusted life years (DALYs) . Effective prediction of the burden of COPD based on its prevalence, mortality and DALYs rate will provide theoretical support for the formulation of prevention and control measures.

To describe and analyze the burden of COPD and its temporal trends from 1990 to 2019, and to forecast the COPD burden between 2020 and 2024 in China, provide a basis for scientific prevention and control of COPD in China.

In December 2021, data about indicators measuring the burden of COPD in China from 1990—2019, including COPD prevalence, mortality and DALYs rates, were extracted from the Global Burden of Disease 2019. The average annual percentage change was used to measure the temporal trend of COPD prevalence, mortality and DALYs rates over the period. Autoregressive moving average (ARIMA) and neural network autoregressive (NNAR) models for COPD prevalence, mortality and DALYs rates were constructed based on data from 1990-2016 (training set) , and their predictive performance was tested using data from 2017—2019 (test set) . The relative error, mean absolute percentage error (MAPE) , mean absolute error (MAE) and root mean square error (RMSE) between predicted and actual values of these two models were calculated for comparing their goodness of fit and predictive performance. And the better model was used to estimate the COPD disease burden from 2020 to 2024.

COPD prevalence, mortality and DALYs rates in China during 1990—2019: (1) The prevalence of COPD in the whole population increased from 2 344.40/100 000 to 3 175.37/100 000, with an average annual growth rate of 1.04%. And the average annual growth rates of COPD prevalence were 0.92% and 1.13% for men and women, respectively. (2) The mortality rate of COPD in the whole population decreased from 105.09/100 000 to 72.94/100 000, with an average annual rate of decrease of 1.29%. And the mortality rates in both men and women showed a decreasing trend, with average annual rates of decrease of 0.83% and 1.83%, respectively. (3) The rate of COPD DALYs in the whole Chinese population decreased from 2 206.55/100 000 to 1 400.71 /100 000, with an average annual rate of decrease of 1.56%. And the rates of DALYs in both men and women showed a decreasing trend, with average annual rates of decrease of 1.37% and 1.86%, respectively. The predicted values of the trends by both ARIMA and NNAR models were basically consistent with the actual values of trends, but the ARIMA model had smaller relative error, MAPE, MAE and RMSE, indicating that it may have better prediction accuracy. And by the ARIMA model, the predicted COPD prevalence in 2020—2024 was 3 229.77/100 000, 3 262.44/100 000, 3 292.38/100 000, 3 322.31/100 000, and 3 352.25/100 000, respectively; the predicted mortality rates were 74.50/100 000, 75.49/100 000, 76.11/100 000, 76.50/100 000, and 76.75/100 000, respectively; the predicted DALYs rates were 1 429.56/100 000, 1 452.07/100 000, 1 469.64/100 000, 1 483.35/100 000, and 1 494.05/100 000, respectively.

The trend of burden of COPD in China was predicted to be increased from 2020 to 2024 by the ARIMA model. Owing to the high goodness of fit and predictive accuracy demonstrated in the prediction, the ARIMA model may be used as a tool for predicting short-term burden of COPD.

中国是慢性阻塞性肺疾病（COPD）疾病负担较为严重的国家之一，COPD已成为中国的第三大致死病因，其在全部疾病伤残调整寿命年（DALYs）排名中位居第三位。基于患病率、死亡率和DALYs率实现对COPD疾病负担的有效预测，可为预防和控制措施的制定提供理论支持。

描述和分析1990—2019年中国COPD疾病负担状况及其变化趋势，并预测2020—2024年中国COPD疾病负担，旨在为中国COPD科学防控提供依据。

于2021年12月，从2019年全球疾病负担（GBD 2019）中提取1990—2019年中国COPD患病率、死亡率及DALYs率等疾病负担指标的数据，采用平均年度变化百分比（AAPC）分析其变化趋势。基于1990—2016年数据（训练集）建立COPD患病率、死亡率及DALYs率的自回归移动平均（ARIMA）模型和神经网络自回归（NNAR）模型，利用2017—2019年数据（测试集）进行模型评价。采用预测值与实际值的相对误差、平均绝对百分误差（MAPE）、平均绝对误差（MAE）和均方根误差（RMSE）比较模型的拟合和预测效果，运用最佳模型预测2020—2024年中国COPD疾病负担。

1990—2019年：中国全人群COPD患病率从2 344.40/10⁵增长至3 175.37/10⁵，年均增长1.04%，男性和女性的COPD患病率平均每年分别增长0.92%和1.13%；中国全人群COPD死亡率由105.09/10⁵下降至72.94/10⁵，年均降幅为1.29%，男性和女性的COPD死亡率均呈下降趋势，平均每年分别下降0.83%和1.83%；中国全人群DALYs率从2 206.55/10⁵下降至1 400.71/10⁵，年均下降1.56%，男性和女性的COPD DALYs率均呈下降趋势，平均每年分别下降1.37%和1.86%。ARIMA和NNAR模型预测值的动态趋势与实际情况基本一致，但ARIMA模型的预测值与实际值相对误差、MAPE、MAE和RMSE更小，预测精度更高。经ARIMA模型预测得到2020—2024年中国COPD患病率分别为3 229.77/10⁵、3 262.44/10⁵、3 292.38/10⁵、3 322.31/10⁵、3 352.25/10⁵，死亡率分别为74.50/10⁵、75.49/10⁵、76.11/10⁵、76.50/10⁵、76.75/10⁵，DALYs率分别为1 429.56/10⁵、1 452.07/10⁵、1 469.64/10⁵、1 483.35/10⁵、1 494.05/10⁵。

2020—2024年中国COPD疾病负担呈现上升趋势，ARIMA模型在拟合中国COPD疾病负担应用中具有良好的拟合效果和精度，可为COPD疾病负担短期预测提供借鉴与参考。