Chapman Kenneth R
Department of Medicine, University of Toronto, Canada.
Clin Chest Med. 2004 Jun;25(2):331-41. doi: 10.1016/j.ccm.2004.01.003.
Current data show that women now suffer from COPD at least as commonly as men. They seem to be more predisposed to suffer the adverse respiratory consequences of tobacco smoking with the development of COPD at an earlier age and with a greater degree of lung function impairment for a given amount of tobacco exposure. This may be explained, in part, by women's greater airway responsiveness to exogenous stimuli--an increased responsiveness that is explained largely by differences in lung size and geometry. Hormonal factors and immunologic factors that influence the lung also may differ between the sexes but their significance is poorly understood. Despite the increasing prevalence of COPD among women, their disease is more likely to be overlooked as compared with the same disease in men. This gender bias in diagnosis is not likely to be remedied until physicians begin to use spirometric testing to screen for this common disease. Women who smoke may have greater difficulty quitting than men. There are documented differences in health care use between men and women who have COPD, but too few studies have been done to allow conclusions to be drawn about the impact of sex and gender on the prognosis of the disease.
目前的数据表明，女性患慢性阻塞性肺疾病（COPD）的情况至少与男性一样普遍。她们似乎更容易因吸烟而遭受不良呼吸后果，患COPD的年龄更早，并且在接触相同量烟草的情况下，肺功能受损程度更大。这在一定程度上可能是由于女性气道对外源刺激的反应性更强——这种反应性增加在很大程度上是由肺大小和形态的差异所解释的。影响肺部的激素因素和免疫因素在性别之间也可能不同，但其重要性尚未得到充分理解。尽管COPD在女性中的患病率不断上升，但与男性患同一种疾病相比，她们的病情更有可能被忽视。在医生开始使用肺活量测定法来筛查这种常见疾病之前，这种诊断中的性别偏见不太可能得到纠正。吸烟的女性可能比男性更难戒烟。有记录显示，患COPD的男性和女性在医疗保健使用方面存在差异，但相关研究太少，无法就性别对该疾病预后的影响得出结论。
