Dubé Bruno-Pierre, Laveneziana Pierantonio
Département de Médecine, Service de Pneumologie, Centre Hospitalier de l'Université de Montréal (CHUM) Montréal, Québec, Canada.
Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) - Carrefour de l'Innovation et de l'Évaluation en Santé, Montréal, Québec, Canada.
J Thorac Dis. 2018 May;10(Suppl 12):S1355-S1366. doi: 10.21037/jtd.2018.02.20.
Chronic obstructive pulmonary disease (COPD) is a prevalent, complex and debilitating disease which imposes a formidable burden on patients and the healthcare system. The recognition that COPD is a multifaceted disease is not new, and increasing evidence have outlined the importance of its extra-pulmonary manifestations and its relation to other comorbid conditions in the clinical course of the disease and its societal cost. The relationship between aging, COPD and its comorbidities on skeletal muscle function and nutritional status is complex, multidirectional and incompletely understood. Despite this, the current body of knowledge allows the identification of various, seemingly partially independent factors related both to the normal aging process and to the independent deleterious effects of chronic diseases on muscle function and body composition. There is a dire need of studies evaluating the relative contribution of each of these factors, and their potential synergistic effects in patients with COPD and advanced age/comorbid conditions, in order to delineate the best course of therapeutic action in this increasingly prevalent population.
慢性阻塞性肺疾病（COPD）是一种常见、复杂且使人衰弱的疾病，给患者和医疗保健系统带来了巨大负担。认识到COPD是一种多方面的疾病并非新鲜事，越来越多的证据表明了其肺外表现的重要性以及在疾病临床过程及其社会成本中它与其他合并症的关系。衰老、COPD及其合并症对骨骼肌功能和营养状况的关系是复杂、多向且尚未完全理解的。尽管如此，目前的知识体系能够识别出各种看似部分独立的因素，这些因素既与正常衰老过程有关，也与慢性病对肌肉功能和身体组成的独立有害影响有关。迫切需要开展研究，评估这些因素各自的相对作用，以及它们在COPD患者和高龄/合并症患者中的潜在协同效应，以便在这一日益普遍的人群中确定最佳治疗方案。
