University of Crete, Medical School, Crete, Greece.
Institute of Inflammation and Repair, University of Manchester, UK.
Respir Med. 2018 Jul;140:127-131. doi: 10.1016/j.rmed.2018.06.007. Epub 2018 Jun 5.
Chronic Obstructive Pulmonary Disease (COPD) is very a common, with great morbidity and mortality, disease. Since the beginning of the disease cannot be detected with precision and by using only FEV1 to monitor the evolution of the disease, the Natural History of COPD is rather obscure and sometimes controversial. Therefore, the terms EARLY COPD and MILD COPD have been used indistinguishably in the medical literature. In this review we discuss the two terms trying to clarify some of the definition issues, starting with a synopsis of the Naturel History of the disease. We recommend to use the term EARLY COPD for the pre-clinical stage of the disease (stage 0) and the term MILD COPD when the diagnosis is confirmed by spirometry and FEV1 is above 80% predicted. However, COPD is a complex disease and spirometric evaluation alone (MILD COPD, stage I), cannot fully describe the clinical status of the patient. We conclude that biomarkers to detect the starting point and been able to follow the natural history of the disease more accurately, beyond FEV, are urgently needed.
慢性阻塞性肺疾病（COPD）是一种非常常见的疾病，具有很高的发病率和死亡率。由于疾病的早期阶段无法精确检测到，并且只能使用 FEV1 来监测疾病的进展，因此 COPD 的自然史相当模糊，有时甚至存在争议。因此，在医学文献中，EARLY COPD 和 MILD COPD 这两个术语经常被混淆使用。在这篇综述中，我们讨论了这两个术语，试图澄清一些定义问题，首先概述疾病的自然史。我们建议将 EARLY COPD 用于疾病的临床前阶段（阶段 0），而将 MILD COPD 用于通过肺量计诊断并 FEV1 高于预测值的 80%时使用。然而，COPD 是一种复杂的疾病，仅通过肺量计评估（MILD COPD，阶段 I）无法完全描述患者的临床状况。我们得出结论，迫切需要能够检测疾病起始点并能更准确地跟踪疾病自然史的生物标志物，而不仅仅是 FEV。
