School of Medical and Life Science, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610000, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suining, Sichuan, 629000, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2024 Feb 29;19:567-578. doi: 10.2147/COPD.S447739. eCollection 2024.
Most patients with chronic obstructive pulmonary disease (COPD) suffer from at least one additional, clinically relevant chronic disease. To a degree, the high global prevalence and mortality rate of COPD is closely related to its extrapulmonary effects. Moreover, the various of comorbidities of COPD and itself interact with each other, resulting in diverse clinical manifestations and individual differences, and thus further influencing the prognosis as well as healthcare burden of COPD patients. This is closely related to the common risk factors of chronic diseases (aging, smoking, inactivity, etc.). Additionally, some pathophysiological mechanisms caused by COPD, including the systemic inflammatory response, hypoxia, oxidative stress, and others, also have an impact on other systems. But comprehensive management and medical interventions have not yet been established. The clinicians should improve their knowledge and skills in diagnosing as well as treating the comorbidities of COPD, and then aim to develop more individualized, efficient diagnostic and therapeutic strategies for different patients to achieve greater clinical benefits. In this article, we will review the risk factors, mechanisms, and treatment strategies for extrapulmonary comorbidities in chronic obstructive pulmonary disease, including cardiovascular diseases, diabetes, anemia, osteoporosis, emotional disorders, and gastroesophageal reflux disease.
大多数慢性阻塞性肺疾病（COPD）患者至少患有一种其他临床相关的慢性病。在某种程度上，COPD 的高全球患病率和死亡率与其肺外效应密切相关。此外，COPD 和自身的各种合并症相互作用，导致不同的临床表现和个体差异，从而进一步影响 COPD 患者的预后和医疗负担。这与慢性疾病的常见危险因素（衰老、吸烟、不活动等）密切相关。此外，COPD 引起的一些病理生理机制，包括全身炎症反应、缺氧、氧化应激等，也会对其他系统产生影响。但尚未建立全面的管理和医疗干预措施。临床医生应提高对 COPD 合并症的诊断和治疗的认识和技能，然后努力为不同患者制定更个体化、有效的诊断和治疗策略，以实现更大的临床获益。本文将综述慢性阻塞性肺疾病肺外合并症的危险因素、发病机制和治疗策略，包括心血管疾病、糖尿病、贫血、骨质疏松症、情绪障碍和胃食管反流病。
