In the present account it is proposed that in smokers the transition from peripheral airway disease to COPD is characterized by three sequential stages: Stage I, during which the closing volume eventually exceeds the functional residual capacity; Stage II, during which tidal expiratory flow limitation (EFL) is eventually exhibited; and Stage III, during which dynamic hyperinflation progressively increases leading to dyspnea and exercise limitation, which may be considered as markers of overt disease. Presence of airway closure (Stage I) and EFL (Stage II) in the tidal volume range may promote peripheral airway injury and accelerate the abnormalities of lung function. It is such injury that may determine which smoker is destined to develop COPD.

译文

:在目前的研究中,建议吸烟者从周围呼吸道疾病到COPD的转变以三个连续阶段为特征:第一阶段,其关闭量最终超过功能性剩余容量;第二阶段,最终表现为潮气呼气流量限制(EFL);第三阶段,在此期间,动态过度充气会逐渐增加,导致呼吸困难和运动受限,这可能被认为是明显疾病的标志。潮气量范围内存在气道闭合(I期)和EFL(II期)可能会促进周围气道损伤并加速肺功能异常。正是这种伤害可能决定了哪个吸烟者注定会发展为COPD。

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