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降低死亡风险——慢性阻塞性肺疾病患者的一种可能结果。

Reducing the risk of death - a possible outcome in COPD patients.

作者信息

Maniscalco Mauro, Calzetta Luigino, Rogliani Paola, Cazzola Mario

机构信息

Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.

Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, Telese Terme, Italy.

出版信息

Expert Rev Clin Pharmacol. 2024 Sep 26:1-9. doi: 10.1080/17512433.2024.2408272.

Abstract

INTRODUCTION

COPD is a leading cause of global mortality, particularly under-recognized and under-diagnosed. In 2020, it was the sixth leading cause of death in the US and has contributed to 4.72% of all-cause mortality (ACM) according to the Global Burden of Disease Study 2017. Factors influencing COPD-related mortality include smoking, aging populations, comorbidities, sarcopenia, physical capacity, and lack of effective treatments.

AREAS COVERED

This review discusses various factors influencing COPD-related mortality and analyzes observational studies and pivotal RCTs evaluating the impact of different therapies on ACM.

EXPERT OPINION

COPD significantly impacts ACM, necessitating effective management strategies. Smoking cessation is crucial in reducing mortality risk. Exacerbation management and comorbidity treatment are essential to improve patient outcomes. Various therapeutic interventions, such as smoking cessation, vaccination, long-term oxygen therapy, and lung volume reduction surgery, have shown benefits in reducing mortality. Pharmacotherapies might reduce the risk of mortality, although the current scientific evidences remain inconclusive. Advances in pharmacological interventions, tailored treatment plans, and physical activity programs are vital. More robust and long-term studies, focusing on real-world data and addressing biases in treatment allocation, are needed to conclusively determine the efficacy of different therapies in reducing ACM in COPD patients.

摘要

引言

慢性阻塞性肺疾病(COPD)是全球死亡的主要原因之一,尤其未得到充分认识和诊断。2020年,它是美国第六大死因,根据《2017年全球疾病负担研究》,占全因死亡率(ACM)的4.72%。影响COPD相关死亡率的因素包括吸烟、人口老龄化、合并症、肌肉减少症、身体能力以及缺乏有效治疗方法。

涵盖领域

本综述讨论了影响COPD相关死亡率的各种因素,并分析了评估不同疗法对ACM影响的观察性研究和关键随机对照试验(RCT)。

专家意见

COPD对ACM有显著影响,需要有效的管理策略。戒烟对于降低死亡风险至关重要。急性加重期管理和合并症治疗对于改善患者预后至关重要。各种治疗干预措施,如戒烟、疫苗接种、长期氧疗和肺减容手术,已显示出在降低死亡率方面的益处。药物治疗可能会降低死亡风险,尽管目前的科学证据尚无定论。药物干预、量身定制的治疗方案和体育活动计划的进展至关重要。需要进行更有力和长期的研究,关注真实世界数据并解决治疗分配中的偏差,以最终确定不同疗法在降低COPD患者ACM方面的疗效。

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