From COPD to chronic systemic inflammatory syndrome?
From COPD to chronic systemic inflammatory syndrome?
复制标题
DOI：
10.1016/s0140-6736(07)61383-x
复制
发表时间：
2007-09-01
期刊：
影响因子：
168.9
通讯作者：
Rabe, Klaus F.
中科院分区：
文献类型：
--
作者：
Fabbri, Leonardo M.;Rabe, Klaus F.
因此，我们提出了一个全面的方法来诊断，评估的严重程度，并管理COPD及其常见的合并症。对于年龄大于40岁、吸烟史超过10包-年、出现与COPD相一致的临床和功能异常的患者，我们建议不要将诊断方法仅限于COPD，而应寻找更广泛的慢性全身炎症综合征的体征，并详细描述呼吸系统、心血管系统和代谢系统的临床和功能异常。术语慢性是指异常的缓慢和进行性发展;全身性是指危险因素直接或间接同时作用于所有靶器官的事实;炎性是指所有组分与炎症的关联;而综合征是指通常一起出现的几种临床上可识别的特征、体征、症状或特征的关联，使得一个特征的存在警告医生其它特征的存在。慢性全身性炎症综合征的诊断可以通过在面板中列出的六种组分中至少三种的存在来确定。COPD、慢性心力衰竭和代谢综合征是根据现行国际指南1，23-25在肺、心脏和代谢功能综合评估后诊断的。其他慢性疾病，如冠状动脉和外周动脉疾病、贫血、骨质疏松症和类风湿性关节炎，可以作为额外的合并症、并发症（如类固醇诱导的骨质疏松症）或作为慢性综合征严重程度的独立修饰因素（如抑郁症）纳入。
We hereby propose an overarching approach to diagnosis, assessment of severity, and management of COPD and its frequent comorbidities. In patients older than 40 years, with a smoking history of more than 10 pack-years, who develop clinical and functional abnormalities compatible with COPD, we suggest not to restrict the diagnostic approach to COPD alone but to search for signs of the more general disorder chronic systemic inflammatory syndrome, with detailed description of clinical and functional abnormalities of the respiratory, cardiovascular, and metabolic systems. The term chronic refers to the slow and progressive development of the abnormalities; systemic refers to the fact that risk factors act directly or indirectly on all target organs simultaneously; inflammatory refers to the association of all components with inflammation; and syndrome refers to the association of several clinically recognisable features, signs, symptoms, or characteristics that generally arise together, so that the presence of one feature alerts the doctor to the presence of the others. Diagnosis of chronic systemic inflammatory syndrome can be established by the presence of at least three of the six components listed in the panel. COPD, chronic heart failure, and metabolic syndrome are diagnosed according to current international guidelines1, 23–25 after comprehensive assessment of lung, cardiac, and metabolic functions. Other chronic disorders, such as coronary and peripheral artery diseases, anaemia, osteoporosis, and rheumatoid arthritis, could be included either as additional comorbidities, as complications (eg, steroid-induced osteoporosis), or as independent modifiers of severity of the chronic syndrome (eg, depression).