慢性阻塞性肺疾病 (COPD)

目前尚无数据最终证实肺量测定筛查可有效指导管理决策或改善无症状患者的 COPD 结局，美国预防服务工作组（US Preventive Services Task Force, USPSTF）建议勿对此类人群进行筛查。[63]US Preventive Services Task Force. Final recommendation statement: chronic obstructive pulmonary disease: screening. May 2022 [internet publication]. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chronic-obstructive-pulmonary-disease-screening 但是，如果COPD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。[64]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，早期发现病例。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [internet publication]. https://goldcopd.org/2023-gold-report-2 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曾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。