慢性阻塞性肺疾病常见表型、亚型分型及临床意义

Phenotpe, endotype and clinical value of chronic obstructive pulmonary disease classification

慢性阻塞性肺疾病（COPD）是一种复杂性和异质性的疾病，单纯依靠肺功能并不能客观反映出COPD的特性。因此有人提出了表型和亚型的概念，来帮助我们进一步理解COPD。月前报道COPD表型有很多，但被写入国家指南的较常见的主要有：慢性支气管炎、肺气肿、频繁急性加重及哮喘-COPD重叠综合征表型。关于亚型目前研究较多的是中性粒细胞、细菌定植及Th2亚型。日前我们对COPD分型的认识尚处于初步阶段，未来COPD的分型可能会越来越精准，最终目的是达到对COPD的精准治疗。

Chronic obstructive pulmonary disease （COPD） is a complex and heterogeneous disease. Simply relying on lung function can not objectively reflect the characteristics of COPD. Therefore, some people have proposed the concept of phenotype and endotype to help us to understand COPD. At present, there are many phenotypes of COPD, but the most common ones written into the national guidelines are chronic bronchitis, emphysema, frequent acute exacerbation and asthma-COPD overlap syndrome phenotype. Recently more studies are neutrophils, bacterial colonization and Th2 endotypes. We are still in the initial stage of the understanding of COPD. The future classification of COPD may be more and more accurate, the ultimate goal is to achieve the personalized medicine of COPD.