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COPD 早期检测的研究进展:要点与新策略。

Current Progress of COPD Early Detection: Key Points and Novel Strategies.

机构信息

Division of Chest Medicine, Changhua Christian Hospital, Changhua, 500, Taiwan.

Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, 402, Taiwan.

出版信息

Int J Chron Obstruct Pulmon Dis. 2023 Jul 19;18:1511-1524. doi: 10.2147/COPD.S413969. eCollection 2023.

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, with approximately 70% to 80% of adults with COPD being undiagnosed. Patients with undiagnosed COPD are at increased risk of poor outcomes and a worsened quality of life, making early detection a crucial strategy to mitigate the impact of COPD and reduce the burden on healthcare systems. In the past decade, increased interest has been focused on the development of effective strategies and instrument for COPD early detection. However, identifying undiagnosed cases of COPD is still challenging. Both screening and case-finding approaches have been adopted to identify undiagnosed COPD, with case-finding being recommended by the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline and the updated United States Preventive Services Task Force (USPTF) recommendation. Nonetheless, the approaches, criteria, and instruments used for early detection of COPD are varied. However, advances in the taxonomy and risk factors of COPD are continuously being investigated. It is important to continuously assess the current state of knowledge on COPD early detection, given the challenges associated with identifying undiagnosed COPD. This review aims to highlight recent advances in early detection of COPD. To discuss the current challenge and opportunity in COPD early detection, providing an overview of existing literature on COPD case-finding strategies, including the approaches, criteria for subjects, and instruments. The review also summarizes the current progress in COPD case-findings and proposes a COPD case-finding flowchart as an efficient method for identifying at risk COPD patients.

摘要

慢性阻塞性肺疾病(COPD)是全球发病率和死亡率的主要原因,约 70%至 80%的 COPD 患者未被诊断。未被诊断的 COPD 患者发生不良结局和生活质量下降的风险增加,因此早期发现是减轻 COPD 影响和减轻医疗系统负担的关键策略。在过去十年中,人们越来越关注开发有效的 COPD 早期检测策略和工具。然而,识别未被诊断的 COPD 仍然具有挑战性。已经采用了筛查和病例发现方法来识别未被诊断的 COPD,2023 年全球慢性阻塞性肺疾病倡议(GOLD)指南和更新的美国预防服务工作组(USPTF)建议推荐使用病例发现方法。尽管如此,用于 COPD 早期检测的方法、标准和工具仍存在差异。然而,COPD 的分类和危险因素的研究进展仍在不断进行中。鉴于识别未被诊断的 COPD 存在挑战,因此不断评估 COPD 早期检测的现有知识状态非常重要。本综述旨在强调 COPD 早期检测的最新进展。为了讨论 COPD 早期检测的当前挑战和机遇,本文综述了现有的 COPD 病例发现策略文献,包括方法、研究对象标准和工具。本文还总结了 COPD 病例发现的最新进展,并提出了一个 COPD 病例发现流程图,作为识别高危 COPD 患者的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9f/10363346/a6f23de847e0/COPD-18-1511-g0001.jpg

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