慢性阻塞性肺病
医学
肺活量测定
重症监护医学
恶化
肺病
心理干预
共病
疾病
临床试验
内科学
哮喘
精神科
作者
F Y Wang,Z Y Liang,Yanping Yang,L W Wang,R C Chen
出处
期刊:PubMed
日期:2024-01-12
卷期号:47 (1): 54-59
标识
DOI:10.3760/cma.j.cn112147-20231019-00248
摘要
Chronic obstructive pulmonary disease (COPD) is the most common chronic airway disease, with a high prevalence and high disease burden. Clinical questions have driven advances in clinical research that continue to deepen our understanding of COPD. At the same time, new perspectives, evidence, and strategies have emerged. Studies since 2022 have increased knowledge of the impact of risk factors, such as low-to-moderate income and ambient ozone, on the prevalence of COPD. The effect of preterm birth on obstructive lung function deficits and COPD in the sixth decade of life was investigated for the first time. Screening studies for COPD in developed and low- and middle-income countries suggest the importance of tailoring screening strategies to local conditions. Developments in artificial intelligence provide a general framework for using machine-learning-based methods and medical record-based labels to improve disease prediction. New perspectives on endotypes/phenotypes and prognostic assessment of COPD were provided by lifetime spirometry patterns of obstruction and limitation, sensitisation to recombinant Aspergillus fumigatus allergens, airway-occluding mucus plugs and exacerbation history in COPD group A and B patients. Clinical trials focusing on inflammatory mediators, comorbidity treatment, non-pharmacological treatments, and environmental interventions shed light on some crucial and long-debated issues. Further research is needed for individualised diagnosis and treatment of COPD.慢性阻塞性肺疾病(简称慢阻肺)是最常见的慢性气道疾病,发病率居高不下,疾病负担重。临床问题推动了临床研究的不断进展,持续加深着人们对慢阻肺的认识,也陆续涌现了新的观点、证据和策略。2022年以来的研究,增加了地区低-中收入、环境臭氧等危险因素对患病率影响的知识,首次回答了早产对中年时期肺功能水平和慢阻肺患病风险的影响。在发达国家和低-中收入国家分别开展的慢阻肺筛查试验提示了筛查工具和因地制宜制定筛查策略的重要性。人工智能的发展推动了基于病历标签而不依赖医疗专家的疾病预测模式。肺通气功能障碍的终生发展轨迹、真菌致敏情况、气道黏液栓及低加重风险组患者的既往急性加重史分层为慢阻肺的疾病分型和预后评估提供了新视角。靶向炎症介质、合并症治疗、非药物治疗和环境干预等方面的临床试验阐明了慢阻肺治疗领域一些争论已久的重要问题,也提示慢阻肺的个体化诊疗需要更多深入的探索。.
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