Yamaguchi Kazuhiro
Internal Medicine, Sano Kosei General Hospital.
Nihon Rinsho. 2007 Apr;65(4):657-63.
In the guideline proposed by WHO (GOLD) or by the Japanese Respiratory Society (RS), the diagnosis of COPD is simply made when FEV1/FVC (FEV %) of a given subject after inhalation of short-acting bronchodilator is below 70%. On the other hand, on grounds of measured FEV1/predicted FEV (%FEV1), the disease severity of COPD is categorized into four stages including I (mild), II (moderate), III (severe), and IV(very severe). In addition, very special category defined as stage zero (at-risk group) has been proposed in both guidelines. However, the above-mentioned criteria have many impediments as they are too simple for diagnosing and classifying COPD with a complicated pathophysiology. In this paragraph, the attempt is made not only to comment on the diagnosis criteria and classification of disease severity of COPD provided in GOLD and JRS guidelines but also to investigate the details of the impediments existing in both guidelines.
在世界卫生组织（GOLD）或日本呼吸学会（RS）提出的指南中，当给定受试者吸入短效支气管扩张剂后的FEV1/FVC（FEV%）低于70%时，即可简单做出慢性阻塞性肺疾病（COPD）的诊断。另一方面，根据实测FEV1/预测FEV（%FEV1），COPD的疾病严重程度分为四个阶段，包括I（轻度）、II（中度）、III（重度）和IV（极重度）。此外，在这两个指南中都提出了定义为零期（风险组）的非常特殊的类别。然而，上述标准存在诸多障碍，因为它们对于诊断和分类具有复杂病理生理学的COPD来说过于简单。在本段中，不仅尝试对GOLD和JRS指南中提供的COPD诊断标准和疾病严重程度分类进行评论，还将研究这两个指南中存在的障碍细节。
