Cote Claudia G
Bay Pines Veterans Administration Health Care System, Bay Pines, Florida 33744, USA.
Am J Med. 2006 Oct;119(10 Suppl 1):54-62. doi: 10.1016/j.amjmed.2006.08.008.
Chronic obstructive pulmonary disease (COPD) remains a leading cause of disability and death in the United States. The identification and amelioration of systemic manifestations of COPD may improve long-term outcomes, including survival. These systemic manifestations often correlate with increased risk of mortality and may be considered surrogates of disease severity. Several potential clinical surrogates are evaluated, including airflow obstruction, dyspnea, malnutrition, hypoxemia, exercise capacity, lung hyperinflation, and anemia. The evidence in support of the impact of various COPD treatment modalities on systemic manifestations of COPD is also reviewed. Finally, the usefulness of measuring body mass index, degree of airflow obstruction, dyspnea, and exercise capacity in combination (the BODE index), as a measure of disease severity and mortality risk in COPD, is examined and found to be a simple-to-use tool for predicting COPD-related hospitalization and mortality.
慢性阻塞性肺疾病（COPD）在美国仍然是导致残疾和死亡的主要原因。识别和改善COPD的全身表现可能会改善包括生存率在内的长期预后。这些全身表现通常与死亡风险增加相关，可被视为疾病严重程度的替代指标。文中评估了几种潜在的临床替代指标，包括气流受限、呼吸困难、营养不良、低氧血症、运动能力、肺过度充气和贫血。还综述了支持各种COPD治疗方式对COPD全身表现影响的证据。最后，研究了联合测量体重指数、气流受限程度、呼吸困难和运动能力（BODE指数）作为COPD疾病严重程度和死亡风险衡量指标的有用性，发现它是预测COPD相关住院和死亡的一种易于使用的工具。
