Celli Bartolome, Goldstein Roger, Jardim José, Knobil Katharine
Caritas St. Elizabeth's Medical Center, Department of Medicine, Tufts University, Boston, USA.
Respir Med. 2005 Dec;99 Suppl B:S41-8. doi: 10.1016/j.rmed.2005.09.014. Epub 2005 Oct 26.
The pathophysiology of chronic obstructive pulmonary disease (COPD) is complex. The development of a multidimensional index--such as the BODE index--provides a means of classifying patients with COPD that also correlates with their prognosis. The individual components of the BODE index--body mass index (B), airflow obstruction (O) dyspnoea (D) and exercise capacity (E)--incorporate the pulmonary as well as the systemic effects seen in patients with COPD. Recent research has focussed on examining these impairments (including those of metabolism and inflammation) more carefully, and determining the effects of treatment on both the systemic and physiological aspects of COPD. Ongoing research initiatives by the public and private sector will contribute to our understanding of the disease processes underlying COPD, our understanding of the benefits associated with commonly used pharmacotherapies, as well as laying the foundations for the development of new agents and therapeutic tools. Advances in the use of pharmacotherapy have been mirrored by research to better define the benefits associated with pulmonary rehabilitation. Many questions remain to be answered, but a comprehensive approach is now considered essential to the life-long management of COPD, and will undoubtedly reduce the considerable socio-economic burden of COPD.
慢性阻塞性肺疾病（COPD）的病理生理学很复杂。多维指数（如BODE指数）的发展为COPD患者的分类提供了一种方法，该指数也与患者的预后相关。BODE指数的各个组成部分——体重指数（B）、气流阻塞（O）、呼吸困难（D）和运动能力（E）——包含了COPD患者所表现出的肺部及全身影响。最近的研究集中在更仔细地检查这些损害（包括代谢和炎症方面的损害），以及确定治疗对COPD全身和生理方面的影响。公共和私营部门正在进行的研究计划将有助于我们理解COPD的疾病过程、理解常用药物治疗的益处，也为新药物和治疗工具的开发奠定基础。药物治疗应用方面的进展与旨在更好地确定肺康复益处的研究相互呼应。仍有许多问题有待解答，但现在认为综合方法对COPD的终身管理至关重要，而且无疑将减轻COPD相当大的社会经济负担。
