Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Curr Opin Pulm Med. 2019 Mar;25(2):132-137. doi: 10.1097/MCP.0000000000000553.
Early chronic obstructive pulmonary disease (COPD) is emerging in importance for the clinical and research settings. This review will highlight a proposed definition of early COPD, examine early and midlife factors that lead to development of early COPD and review the literature pertaining to the treatment of mild COPD to gain insight into potential therapeutic approaches for early disease.
Early COPD can be defined as disease occurring in patients younger than 50 years in age with a 10-pack-year or more smoking history and abnormal spirometry, imaging or lung function decline. Childhood exposures (maternal smoking and recurrent respiratory infections), childhood and adult asthma, and smoking affect middle-age lung function. Multiple studies of long-acting muscarinic antagonists (LAMAs) in mild COPD have shown improvements in lung function and symptoms scores. Smoking cessation also has a beneficial effect on longitudinal lung function.
Early COPD is an important manifestation of COPD, with a newly proposed definition and associated risk factors identified. Inferring from studies on mild COPD cohorts, LAMAs and smoking cessation may have a positive effect on longitudinal lung function and symptomatic improvement.
早期慢性阻塞性肺疾病（COPD）在临床和研究领域的重要性日益凸显。本文将重点介绍早期 COPD 的定义，探讨导致早期 COPD 发生的早中期因素，并综述轻度 COPD 的治疗相关文献，以期为早期疾病的潜在治疗方法提供思路。
早期 COPD 可定义为年龄小于 50 岁、吸烟 10 包年或以上且存在肺功能异常、影像学改变或肺功能下降的患者。儿童时期的暴露（母亲吸烟和反复呼吸道感染）、儿童和成人哮喘以及吸烟会影响中年时期的肺功能。多项研究表明，长效抗胆碱能药物（LAMA）治疗轻度 COPD 可改善肺功能和症状评分。戒烟对肺功能的纵向改善也有有益作用。
早期 COPD 是 COPD 的一种重要表现形式，其定义和相关的危险因素已被确定。从轻度 COPD 队列研究推断，LAMA 和戒烟可能对肺功能的纵向改善和症状改善有积极作用。
