Johns Hopkins University School of Medicine, Baltimore, MD, USA.
COPD. 2010 Oct;7(5):375-82. doi: 10.3109/15412555.2010.510160.
Chronic obstructive pulmonary disease (COPD) is a leading and increasing cause of death, the extent of which is underestimated as a consequence of underdiagnosis and underreporting on death certificates. Data from large trials, such as the Lung Health Study, Towards a Revolution in COPD Health (TORCH), Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT), European Respiratory Society Study on Chronic Obstructive Pulmonary Disease (EUROSCOP), and Inhaled Steroids in Obstructive Lung Disease (ISOLDE), have shown that the causes of death in patients with mild COPD are predominantly cancer and cardiovascular disease, but as COPD severity increases, deaths due to non-malignant respiratory disease are increasingly common. In practice, mortality of patients with COPD can be predicted by a variety of measures including: forced expiratory volume in one second (FEV(1)), the ratio of inspiratory and total lung capacities, exercise capacity, dyspnea scores, and composite indices such as the body-mass index (B), degree of airflow obstruction (O), degree of functional dyspnea (D), and exercise capacity (E) (BODE) index. Smoking cessation improves survival in COPD patients, and in select patients with advanced disease, oxygen therapy, lung volume reduction surgery, or lung transplantation may also improve survival.
慢性阻塞性肺疾病（COPD）是主要的致死病因，且其致死人数呈上升趋势。由于诊断不足和死亡证明报告不足，其实际致死人数被低估。大型试验的数据，如肺健康研究（Lung Health Study）、COPD 健康革命研究（TORCH）、噻托溴铵对功能潜在长期影响的认识研究（UPLIFT）、欧洲呼吸学会 COPD 研究（EUROSCOP）和吸入性皮质类固醇治疗阻塞性肺病（ISOLDE）表明，轻度 COPD 患者的主要死因是癌症和心血管疾病，但随着 COPD 严重程度的增加，非恶性呼吸道疾病导致的死亡越来越常见。实际上，多种指标都可以预测 COPD 患者的死亡率，包括：第一秒用力呼气量（FEV1）、吸气量与肺总量之比、运动能力、呼吸困难评分以及体质量指数（BMI）、气流阻塞程度（O）、功能性呼吸困难程度（D）和运动能力（E）的综合指数（BODE 指数）。戒烟可改善 COPD 患者的生存状况，对于一些晚期疾病患者，氧疗、肺减容术或肺移植也可能改善生存状况。
