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慢性阻塞性肺疾病(COPD)患者病情加重的早期识别

Early Identification of Exacerbations in Patients with Chronic Obstructive Pulmonary Disease (COPD).

作者信息

Voulgareli Ilektra, Antonogiannaki Elvira-Markela, Bartziokas Konstantinos, Zaneli Stavrina, Bakakos Petros, Loukides Stelios, Papaioannou Andriana I

机构信息

2nd Respiratory Medicine Department, "Attikon" University Hospital, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece.

Independent Researcher, 42131 Trikala, Greece.

出版信息

J Clin Med. 2025 Jan 10;14(2):397. doi: 10.3390/jcm14020397.

Abstract

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) have a substantial effect on overall disease management, health system costs, and patient outcomes. However, exacerbations are often underdiagnosed or recognized with great delay due to several factors such as patients' inability to differentiate between acute episodes and symptom fluctuations, delays in seeking medical assistance, and disparities in dyspnea perception. Self-management intervention plans, telehealth and smartphone-based programs provide educational material, counseling, virtual hospitals and telerehabilitation, and help COPD patients to identify exacerbations early. Moreover, biomarkers such as blood eosinophil count, fibrinogen, CRP, Serum amyloid A(SAA),together with imaging parameters such as the pulmonary artery-to-aorta diameter ratio, have emerged as potential predictors of exacerbations, yet their clinical utility is limited by variability and lack of specificity. In this review, we provide information regarding the importance of the early identification of exacerbation events in COPD patients and the available methods which can be used for this purpose.

摘要

慢性阻塞性肺疾病(COPD)急性加重对整体疾病管理、卫生系统成本和患者预后有重大影响。然而,由于多种因素,如患者无法区分急性发作和症状波动、寻求医疗帮助延迟以及呼吸困难感知差异等,急性加重往往诊断不足或延迟很久才被发现。自我管理干预计划、远程医疗和基于智能手机的项目提供教育材料、咨询、虚拟医院和远程康复服务,帮助慢性阻塞性肺疾病患者早期识别急性加重。此外,血液嗜酸性粒细胞计数、纤维蛋白原、CRP、血清淀粉样蛋白A(SAA)等生物标志物,以及肺动脉与主动脉直径比等影像学参数,已成为急性加重的潜在预测指标,但其临床应用因变异性和缺乏特异性而受到限制。在本综述中,我们提供了有关早期识别慢性阻塞性肺疾病患者急性加重事件的重要性以及可用于此目的的现有方法的信息。

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