Gross Nicholas J
stritch-Loyola School of Medicine, Hines VA Hospital, Chicago, IL, USA.
Proc Am Thorac Soc. 2005;2(4):267-71; discussion 290-1. doi: 10.1513/pats.200504-036SR.
The severity of chronic obstructive pulmonary disease (COPD) and patients' response to therapy are difficult to assess. The traditional measure, spirometry, correlates poorly with important clinical features of the disease, such as survival and quality of life (QOL). Moreover, COPD has recently been recognized as a systemic disease, and its systemic manifestations, such as weight loss and muscle weakness, are only poorly related to lung function. Therefore, although lung function remains an important outcome, other outcomes must be included in any overall assessment of disease severity or response to interventions. Examples include refinements of spirometry, such as measurement of FEV6 and inspiratory capacity; functional outcomes, such as dyspnea indexes and exercise tests; and global-clinical outcomes, such as QOL questionnaires and assessment of frequency and severity of acute exacerbations. For scoring disease severity, making a prognosis, or determining the outcome of novel interventions, composite measures need to be developed that take into account as many aspects of COPD as practicable.
慢性阻塞性肺疾病（COPD）的严重程度以及患者对治疗的反应很难评估。传统的测量方法，即肺量计检查，与该疾病的重要临床特征，如生存率和生活质量（QOL）的相关性较差。此外，COPD最近被认为是一种全身性疾病，其全身表现，如体重减轻和肌肉无力，与肺功能的关系也很弱。因此，尽管肺功能仍然是一个重要的结果，但在对疾病严重程度或干预反应的任何总体评估中，都必须纳入其他结果。示例包括肺量计检查的改进，如FEV6和吸气量的测量；功能结果，如呼吸困难指数和运动测试；以及整体临床结果，如QOL问卷和急性加重发作的频率和严重程度评估。为了对疾病严重程度进行评分、做出预后判断或确定新干预措施的结果，需要制定综合测量方法，尽可能多地考虑COPD的各个方面。
