Pelkonen Margit
Department of Pulmonary Diseases, Kuopio University Hospital, Kuopio, Finland.
Curr Opin Pulm Med. 2008 Mar;14(2):105-9. doi: 10.1097/MCP.0b013e3282f379e9.
To describe the recent findings concerning the relationship between smoking, chronic bronchitis, chronic obstructive pulmonary disease and mortality.
During their lifetime, over 40% of smokers develop chronic bronchitis. Chronic bronchitis is associated with an accelerated decline in lung function - a risk of developing chronic obstructive pulmonary disease and mortality. Approximately one-quarter of smokers can be affected by clinically significant chronic obstructive pulmonary disease. The incidence of chronic obstructive pulmonary disease is also substantial in young adults. Smokers may reduce their risk of developing chronic obstructive pulmonary disease by physical activity and increase their survival by smoking reduction. In adults and the elderly population, severe chronic obstructive pulmonary disease is associated with the most rapid decline in lung function, which is, in turn, associated with chronic obstructive pulmonary disease-related hospitalization and mortality. Using a fixed forced expiratory volume in 1 s/force vital capacity ratio (0.7) to define obstruction in chronic obstructive pulmonary disease at old age is acceptable. In chronic obstructive pulmonary disease patients, the disease is still underreported on death certificates. Chronic mucus production and being a female are associated with chronic obstructive pulmonary disease mentioned on death certificates.
Chronic bronchitis is a marker identifying high-risk individuals. With respect to chronic obstructive pulmonary disease and mortality, interventions to promote smoking cessation are important to reduce these risks.
描述近期关于吸烟、慢性支气管炎、慢性阻塞性肺疾病与死亡率之间关系的研究结果。
在吸烟者一生中，超过40%会患慢性支气管炎。慢性支气管炎与肺功能加速下降相关——这是患慢性阻塞性肺疾病和死亡的风险因素。约四分之一的吸烟者可能会受到具有临床意义的慢性阻塞性肺疾病的影响。慢性阻塞性肺疾病在年轻人中的发病率也很高。吸烟者可通过体育活动降低患慢性阻塞性肺疾病的风险，并通过减少吸烟量提高生存率。在成年人和老年人群中，重度慢性阻塞性肺疾病与肺功能下降最快相关，而这又与慢性阻塞性肺疾病相关的住院治疗和死亡率相关。采用固定的1秒用力呼气容积/用力肺活量比值（0.7）来定义老年人慢性阻塞性肺疾病中的气流受限是可以接受的。在慢性阻塞性肺疾病患者中，死亡证明上对该疾病的报告仍然不足。慢性黏液分泌和女性与死亡证明上提及的慢性阻塞性肺疾病相关。
慢性支气管炎是识别高危个体的一个标志。就慢性阻塞性肺疾病和死亡率而言，促进戒烟的干预措施对于降低这些风险很重要。
