Institute of Health and Society, Université Catholique de Louvain, IRSS, Clos Chapelle-aux-Champs, 30/10.15, 1200, Brussels, Belgium.
Department of Family Medicine, Northern State Medical University, pr. Troitsky, 51, 163000, Arkhangelsk, Russia.
NPJ Prim Care Respir Med. 2017 Nov 14;27(1):62. doi: 10.1038/s41533-017-0062-6.
A hallmark of the diagnosis of chronic obstructive pulmonary disease (COPD) is the measurement of post-bronchodilator (post-BD) airflow obstruction (AO) by spirometry, but spirometry is not enough for the provision of a clinical diagnosis. In the majority of previous epidemiological studies, COPD diagnosis has been based on spirometry and a few clinical characteristics. The aim of our study was to identify outcomes in patients newly diagnosed with airflow obstruction (AO) based on a diagnostic work-up conducted as part of a population-based cross-sectional study in North-Western Russia. Spirometry was performed before (pre-BD) and after BD administration, and AO was defined using the FEV1/FVC <0.70 and FEV1/FVC <lower limit of normal cut-off values. Relevant symptoms were recorded. Participants with AO identified at baseline were then examined by a pulmonologist, including a clinical examination and second spirometry with BD test. Of the 102 participants with post-BD AO in the initial assessment, only 60.8% still had AO identified at the second examination; among these patients, the following final diagnoses were reported: COPD (n = 41), asthma (n = 5), asthma-COPD overlap syndrome (ACOS) (n = 4) and likely ACOS (n = 5). Of the 65 participants with pre-BD AO, 23.1% had post-BD AO at the second assessment, and these patients had been diagnosed with COPD (n = 12), asthma (n = 1), ACOS (n = 1), likely ACOS (n = 1). Serial spirometric assessments complemented by a comprehensive clinical evaluation are recommended in new epidemiological studies.
慢性阻塞性肺疾病（COPD）的诊断标志之一是通过肺量计测量支气管扩张剂后（后 BD）气流受限（AO），但肺量计对于提供临床诊断还不够。在以前的大多数流行病学研究中，COPD 的诊断是基于肺量计和一些临床特征。我们的研究目的是确定在俄罗斯西北部进行的一项基于人群的横断面研究中，根据诊断性检查新诊断为气流受限（AO）的患者的结局。在支气管扩张剂治疗前（前 BD）和治疗后进行肺量计检查，AO 定义为 FEV1/FVC<0.70 和 FEV1/FVC<正常下限的截断值。记录了相关症状。在基线时发现 AO 的参与者随后由肺病专家进行检查，包括临床检查和第二次支气管扩张剂试验后的肺量计检查。在初始评估中，有 102 名参与者存在后 BD AO，只有 60.8%在第二次检查中仍存在 AO；在这些患者中，报告了以下最终诊断：COPD（n=41）、哮喘（n=5）、哮喘-COPD 重叠综合征（ACOS）（n=4）和可能的 ACOS（n=5）。在有前 BD AO 的 65 名参与者中，有 23.1%在后 BD 评估中存在 AO，这些患者被诊断为 COPD（n=12）、哮喘（n=1）、ACOS（n=1）、可能的 ACOS（n=1）。建议在新的流行病学研究中进行系列肺量计评估，并结合全面的临床评估。
