Cosío Borja G, Rodríguez Rosado Jaime
Servicio de Neumología, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España.
Arch Bronconeumol. 2011 Apr;47 Suppl 2:32-7. doi: 10.1016/S0300-2896(11)70019-9.
Chronic obstructive pulmonary disease (COPD) is characterized by inflammation causing airflow obstruction. However, the initial histological lesion of COPD occurs in the respiratory bronchiole and spirometry is unable to detect involvement of this area until the disease is advanced. Major advances have been made in characterizing the inflammatory process in the small airways. However, in clinical practice, a non-invasive marker of small airways involvement, which would allow injury and the effect of treatment to be monitored, is lacking. To date, the combination of bronchodilators and inhaled corticosteroids is recommended for the most severe cases, although the effects of this therapeutic option on the small airways are not well known. New treatments that reach the distal airways and novel techniques to assess the small airways will allow a more complete approach to this disease.
慢性阻塞性肺疾病（COPD）的特征是炎症导致气流阻塞。然而，COPD最初的组织学病变发生在呼吸性细支气管，在疾病进展之前，肺量计无法检测到该区域的受累情况。在表征小气道炎症过程方面已经取得了重大进展。然而，在临床实践中，缺乏一种能够监测小气道受累情况、损伤及治疗效果的非侵入性标志物。迄今为止，对于最严重的病例，推荐使用支气管扩张剂和吸入性糖皮质激素联合治疗，尽管这种治疗方案对小气道的影响尚不清楚。能够到达远端气道的新疗法以及评估小气道的新技术将为这种疾病提供更全面的治疗方法。
