Surgical Diagnosis
Surgical Diagnosis
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手术诊断
DOI：
10.1136/bmj.1.6059.515-a
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发表时间：
1977
影响因子：
--
通讯作者：
Harold Ellis
中科院分区：
文献类型：
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作者：
Harold Ellis
描述了最大的前瞻性研究的临床前阶段的慢性支气管炎尚未报告，这本书是显着的两个方面。首先，它说明了由一个专门的工作人员团队持续多年的相对简单的观察在阐明一种常见疾病的自然史方面的价值。其次，它表明，如果这种类型的研究是精心策划和勤奋执行的专家统计分析可以产生直接，明确的，往往是意想不到的结论。作者在慢性支气管炎的研究中最有效地运用了这些技术，并为彻底重新评价关于该疾病发病机制的传统观点提供了令人信服的理由。特别重要的是区分慢性支气管炎的阻塞型和分泌过多型，以及它们的症状。结论慢性阻塞性肺疾病急性感染加重并不像人们普遍认为的那样，会导致永久性的呼吸能力丧失。另一个相关的观察是，一些吸烟者比其他人更容易发展气流阻塞。吸烟显然是造成大多数慢性支气管炎的原因，如果奇迹发生，大多数人都放弃了吸烟的习惯，这种疾病的发病率无疑会大大降低。然而，似乎其他尚未确定的因素也与气流阻塞和粘液分泌过多有关。如果我们能够确定那些预先确定增加的易感性，一些吸烟者慢性支气管炎，特别是阻塞性形式的障碍，这方面的知识将，正如作者指出的那样，在预测疾病的过程中有相当大的价值，它也可能提供一个更合理的方法来预防和治疗的实际方面的基础。这本书很可能是慢性支气管炎和相关疾病的书目里程碑。这本书不仅在英国值得广泛阅读，而且在那些对这种常见疾病所带来的问题了解得更少的国家也值得广泛阅读。
Describing the largest prospective study of the preclinical stages of chronic bronchitis yet reported, this book is remarkable in two ways. First, it illustrates the value of relatively simple observations continued over a number of years by a dedicated team of workers in elucidating the natural history of a common disease. Secondly, it shows that if a study ofthis type is carefully planned and diligently executed expert statistical analysis can produce straightforward, unambiguous, and often unexpected conclusions. The authors have employed these techniques most effectively in their study of chronic bronchitis and have made a cogent case for a drastic reappraisal of traditional views on the pathogenesis of that disease. Of particular importance is the distinction made between the obstructive and hypersecretory forms of chronic bronchitis, and their. conclusion that acute infective exacerbations of chronic obstructive lung disease do not, contrary to popular belief, cause a permanent loss of ventilatory capacity. Another pertinent observation is that some cigarette smokers are more liable than others to develop airflow obstruction. Smoking is clearly responsible for most cases of chronic bronchitis, and the incidence of the disease would undoubtedly diminish dramatically if, by some miracle, the habit were to be abandoned by the majority of the population. It would appear, however, that other as yet undertermined factors are implicated in the production of airflow obstruction and mucus hypersecretion. If we could identify those which predetermine the increased susceptibility of some smokers to chronic bronchitis, particularly the obstructive form of the disorder, this knowledge would, as the authors point out, be of considerable value in predicting the course of the disease, and it might also provide the basis for a more rational approach to the practical aspects of prevention and treatment. This book could well be a milestone in the bibliography of chronic bronchitis and related disorders. It deserves to be widely read not only in Britain but also in those countries where the problems posed by this common disease are even less clearly understood.