Center for Stroke Research Berlin, Charité Medical School, Berlin, Germany.
Respir Med. 2011 Oct;105 Suppl 1:S12-9. doi: 10.1016/S0954-6111(11)70005-1.
Patients with chronic obstructive pulmonary disease (COPD) are often characterised by a range of characteristic co-morbidities that interfere with their pulmonary disease. In addition to a mere association with co-morbidities, a complex pathophysiological interaction and mutual augmentation occurs between COPD and its co-morbidities that may result in disease progression and increased morbidity and mortality. An interdisciplinary approach is required both for diagnosis and treatment to target co-morbidities early in the course of the disease. This review summarizes the current knowledge of the interaction with cerebrovascular disease and endocrinological co-morbidities in COPD patients. There is growing evidence that COPD is an independent risk factor for ischemic stroke, increasing the risk about twofold. Stroke risk in COPD patients increases with the severity of the disease as measured by the degree of airflow limitation. The presence of cardiovascular risk factors is of particular importance for stroke prevention in COPD patients. Endocrinological co-morbidities are also important and many are associated with increased cardiovascular risk. Impaired glucose metabolism ranges from insulin resistance to overt diabetes mellitus, which is a frequent finding and is associated with worse outcome.
慢性阻塞性肺疾病（COPD）患者常伴有一系列特征性的合并症，这些合并症会干扰他们的肺部疾病。除了与合并症的单纯关联外，COPD 与其合并症之间还存在复杂的病理生理相互作用和相互增强，这可能导致疾病进展和发病率及死亡率增加。在疾病早期，需要采用跨学科方法来诊断和治疗合并症。本文综述了 COPD 患者脑血管病和内分泌合并症相互作用的最新知识。越来越多的证据表明，COPD 是缺血性卒中的独立危险因素，使卒中风险增加约两倍。COPD 患者的卒中风险随着气流受限程度等疾病严重程度的增加而增加。心血管危险因素的存在对 COPD 患者的卒中预防尤为重要。内分泌合并症也很重要，许多与增加的心血管风险相关。糖代谢受损从胰岛素抵抗到显性糖尿病不等，这是一种常见的发现，并与更差的结局相关。
