GOLD与GLI联合声明：使用肺量计定义气流阻塞并诊断慢阻肺

原文

GOLD and GLI agree on many important issues regarding diagnosing COPD with spirometry, sharing concerns about under-use and agreeing that, in the appropriate clinical context, the fixed ratio can be used to identify COPD-related airflow obstruction https://bit.ly/4tB8cZt COPD is one of the leading causes of morbidity and mortality worldwide [1]. Spirometry provides an objective measure of airflow obstruction that, in the appropriate clinical context, confirms the diagnosis of COPD. However, globally, access to spirometry is limited, the test is under-utilised, and many people are either misdiagnosed [2] or under-diagnosed [3, 4]. The intrathoracic airway obstruction that characterises COPD can be detected by finding expiratory flow limitation on spirometry. A reduced forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio demonstrates flow limitation, but for more than 30 years there has been an unproductive debate about which threshold should be used to define airflow limitation and identify airway obstruction in patients with suspected COPD. In this viewpoint article, we focus on the use of spirometry use in routine clinical practice to confirm or exclude a diagnosis of COPD, and aim to propose a way forward to end the debate.