Silverman E K, Speizer F E
Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Med Clin North Am. 1996 May;80(3):501-22. doi: 10.1016/s0025-7125(05)70451-x.
Cigarette smoking clearly has been shown to be the major environmental risk factor predisposing to the development of COPD. Occupational exposures to dust and fumes, air pollution, passive smoke exposure, childhood respiratory infections, and diet may also contribute. Airway hyperresponsiveness is a risk factor for the development of decline in FEV1, but its role in the development of COPD remains uncertain. Alpha1-antitrypsin deficiency is an important genetic risk factor for COPD in the small minority of COPD patients who inherit this deficiency. Other genetic factors are likely involved but have not yet been identified. Elucidation of additional genetic risk factors may provide useful insights into the pathogenesis of COPD. Potential interactions between the various environmental and genetic risk factors may be extremely important in determining the variable development of COPD.
吸烟显然已被证明是导致慢性阻塞性肺疾病（COPD）发生的主要环境风险因素。职业性接触粉尘和烟雾、空气污染、被动吸烟、儿童期呼吸道感染以及饮食也可能起作用。气道高反应性是第一秒用力呼气容积（FEV1）下降的一个风险因素，但其在COPD发生中的作用仍不确定。α1-抗胰蛋白酶缺乏是少数遗传性COPD患者发生COPD的一个重要遗传风险因素。可能还涉及其他遗传因素，但尚未得到确认。阐明更多的遗传风险因素可能为COPD的发病机制提供有用的见解。各种环境和遗传风险因素之间的潜在相互作用在决定COPD的不同发展过程中可能极其重要。
