Putcha Nirupama, Drummond M Bradley, Wise Robert A, Hansel Nadia N
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
Semin Respir Crit Care Med. 2015 Aug;36(4):575-91. doi: 10.1055/s-0035-1556063. Epub 2015 Aug 3.
Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies.
合并症影响着很大一部分慢性阻塞性肺疾病（COPD）患者，据估计，超过80%的COPD患者至少有一种合并的慢性疾病。COPD治疗指南刚刚将合并症纳入其COPD管理建议中，越来越明显的是，多重疾病以及特定合并症与COPD的死亡率和临床结局密切相关，包括呼吸困难、运动能力、生活质量、医疗保健利用和急性加重风险。相应地，人们越来越关注描述COPD人群中合并症的负担，并将这些信息纳入现有的努力中，以更好地了解该群体的临床和表型异质性。在本文中，我们总结了关于COPD合并症负担和特定合并症的现有知识，重点关注患病率估计、与结局的关联以及关于治疗策略的现有知识。
