目前没有数据最终证实肺量测定筛查在指导管理决策或改善无症状患者的 COPD 结局方面有效。[39]Siu AL, Bibbins-Domingo K, et al. Screening for chronic obstructive pulmonary disease: US Preventive Services Task Force recommendation statement. JAMA. 2016 Apr 5;315(13):1372-7.
https://www.doi.org/10.1001/jama.2016.2638
http://www.ncbi.nlm.nih.gov/pubmed/27046365?tool=bestpractice.com
但是,如果慢阻肺在早期诊断出来并去除危险因素,肺功能下降速率将显著延缓。[40]Welte T, Vogelmeier C, Papi A. COPD: early diagnosis and treatment to slow disease progression. Int J Clin Pract. 2015 Mar;69(3):336-49.
https://www.doi.org/10.1111/ijcp.12522
http://www.ncbi.nlm.nih.gov/pubmed/25363328?tool=bestpractice.com
慢性阻塞性肺疾病全球倡议(Global Initiative for Chronic Obstructive Lung Disease, GOLD)指南主张通过对有 COPD 症状和/或危险因素的患者进行肺量测定,积极寻找病例。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2021 [internet publication].
https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
英国指南建议,对所有 35 岁及以上且有慢性咳嗽的当前或既往吸烟者进行肺量测定,以在早期阶段发现病例。临床医生还应考虑对所有胸部 X 线检查或胸部计算机体层成像检查发现肺气肿的患者进行肺量测定筛查。[2]National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. July 2019 [internet publication].
https://www.nice.org.uk/guidance/ng115
在无症状吸烟者中,可能出现严重的肺功能障碍。