Tufts University, St. Elizabeth's Medical Center, 736 Cambridge St., Boston, MA 02135, USA.
Respir Med. 2010 Jun;104(6):773-9. doi: 10.1016/j.rmed.2009.12.017. Epub 2010 Apr 22.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in adults. Although FEV(1) remains the most important physiologic indicator of the severity of airflow obstruction in COPD, its predictive value for mortality is weak when it is higher than 50% of predicted. Furthermore, other easily obtainable clinical variables predict mortality better than the FEV(1) in COPD patients with a wide range of airflow limitation. Chief among these predictors are functional dyspnea, exercise capacity, and the body mass index (BMI), although emerging research suggests a potential role for biomarker profiles in outcome predictions. The validated multidimensional BMI (B), degree of airflow obstruction as expressed by the FEV(1) (O), dyspnea with the modified medical research council (D), and exercise (E) measured with the 6min walk or BODE index encompasses the predictive validity of the best of these variables into a single surrogate measure of disease severity and survival. This article reviews these predictors of mortality in COPD.
慢性阻塞性肺疾病（COPD）是成年人发病率和死亡率的主要原因。虽然 FEV(1) 仍然是 COPD 气流阻塞严重程度的最重要生理指标，但当它高于预测值的 50%时，其对死亡率的预测价值较弱。此外，在气流受限范围广泛的 COPD 患者中，其他更容易获得的临床变量比 FEV(1) 更能预测死亡率。这些预测因素中最重要的是功能性呼吸困难、运动能力和体重指数（BMI），尽管新出现的研究表明生物标志物谱在预后预测中可能发挥作用。经过验证的多维 BMI（B）、FEV(1) 表达的气流阻塞程度（O）、改良医学研究委员会呼吸困难量表（D）和 6 分钟步行或 BODE 指数测量的运动能力（E）将这些变量中的最佳预测价值纳入到一个单一的疾病严重程度和生存的替代指标中。本文综述了 COPD 患者的这些死亡率预测因素。
