Racineux J L, Vidal J F, Meslier N
Service de pneumologie, CHU, Angers.
Rev Prat. 1993 May 15;43(10):1223-6.
Cigarette smoke exerts significant deleterious effects on both lung structures and function. Tobacco alone is the most important risk factor for the development of chronic obstructive lung disease (COLD). The responsibility of smoking for the occurrence of COLD has been demonstrated by epidemiological studies and anatomicopathological findings. Smoking-related lesions initially involve the small airways and remain silent for a long time. There are still uncertainties concerning the mechanisms through which some smokers develop clinical COLD. The clinical diagnosis of COLD rests on the demonstration of dyspnoea by meticulous questioning. Only respiratory function tests can assert the presence of bronchial obstruction. These tests also are necessary to evaluate the severity of the disease, determine its prognosis and follow up its course. In clinical practice the early diagnosis of COLD rests on repeated measurements of FEV1 in smokers.
香烟烟雾对肺部结构和功能均有显著的有害影响。仅烟草一项就是慢性阻塞性肺病（COLD）发展的最重要风险因素。流行病学研究和解剖病理学发现已证实吸烟是导致COLD发生的原因。吸烟相关病变最初累及小气道，且在很长一段时间内没有症状。对于一些吸烟者发展为临床COLD的机制仍存在不确定性。COLD的临床诊断依赖于通过细致询问来证实呼吸困难。只有呼吸功能测试才能确定是否存在支气管阻塞。这些测试对于评估疾病的严重程度、确定其预后以及跟踪病程也是必要的。在临床实践中，COLD的早期诊断依赖于对吸烟者反复测量第一秒用力呼气容积（FEV1）。
