What is a COPD-Like Spirometry Test Result in Resource Constrained Settings?
What is a COPD-Like Spirometry Test Result in Resource Constrained Settings?
复制标题
在资源有限的环境中，类似慢性阻塞性肺病 (COPD) 的肺活量测定结果是什么？
DOI：
10.1080/15412555.2019.1641794
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发表时间：
2019
期刊：
影响因子：
2.2
通讯作者：
Hurst,JohnR
中科院分区：
文献类型：
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作者：
Gianella,GonzaloE;Miranda,JJaime;Hurst,JohnR
慢性阻塞性肺病 (COPD) 这一全球性健康问题的诊断在资源有限的环境中具有挑战性。诊断慢性阻塞性肺病需要使用支气管扩张剂后进行肺量测定显示阻塞模式。现有的慢性阻塞性肺病治疗指南主要来源于对吸烟者人群进行的研究，推荐的药物干预措施倾向于将新的和昂贵的药物作为一线药物。由于导致非吸烟者发展为慢性阻塞性肺病的不同因素会导致不同的疾病表型，因此不能推断慢性阻塞性肺病的严重程度和治疗效果与吸烟者人群相同。这样做时，当前的全球举措在试图过度简化诊断方法并推动不针对具体情况的治疗算法标准化时可能会带来风险。未来减轻慢性阻塞性肺病全球负担的工作需要解决对新流行病学数据的需求，特别是在烟草使用不太普遍且国内空气污染等环境因素常见的地区。
The diagnosis of chronic obstructive pulmonary disease (COPD), a global health problem, is challenging in resource-constrained settings. Spirometry with an obstructive pattern after the administration of bronchodilators is required for the diagnosis of COPD. Existing COPD treatment guidelines, largely derived from studies performed in populations of cigarette-smokers, recommend pharmacologic interventions with a tendency to include new—and expensive—drugs as first line agents. As the different factors that cause nonsmokers to develop COPD lead to different phenotypes of disease, COPD severity and treatment efficacy cannot be extrapolated to be the same as in the population of smokers. In so doing, current global initiatives may carry risks when trying to over simplify diagnostic approaches and push for standardization of treatment algorithms that are not context-specific. Future work to mitigate the global burden of COPD needs to address the need for new epidemiological data, especially in areas where tobacco use is less prevalent and environmental factors such as domestic air pollution is common.