超越FEV1：多维肺功能指标在COPD精细评估与预后判断中的整合应用
Beyond FEV1: Integrated Application of Multidimensional Pulmonary Function Indices in the Precise Assessment and Prognosis Evaluation of COPD
摘要: 慢性阻塞性肺疾病(COPD)是一种具有高度异质性的慢性呼吸系统疾病，传统以第一秒用力呼气量(FEV1)为核心的评估体系存在显著局限性——无法充分反映肺组织破坏、气体交换障碍、症状负担及预后差异。本文系统综述了多维肺功能指标(包括肺弥散功能、肺容积、小气道功能、运动心肺功能及影像学关联指标)在COPD评估中的价值，重点阐述其在解析病理生理机制、表型分层、预后预测及治疗反应监测中的关键作用，进一步提出多维指标的整合策略，包括构建“功能–影像–症状”表型分层模型、联合评分系统用于预后评估，以及临床实践中的转化路径。
Abstract: Chronic Obstructive Pulmonary Disease (COPD) is a highly heterogeneous chronic respiratory condition. The traditional assessment framework, centered on Forced Expiratory Volume in one second (FEV1), has significant limitations—it fails to adequately reflect parenchymal destruction, gas exchange impairment, symptom burden, and prognostic variability. This article systematically reviews the value of multidimensional pulmonary function indices—including diffusing capacity, lung volumes, small airway function, cardiopulmonary exercise testing (CPET) parameters, and imaging-based metrics—in the evaluation of COPD. It highlights their crucial roles in elucidating pathophysiological mechanisms, phenotyping, predicting prognosis, and monitoring treatment response. Furthermore, the paper proposes integrated strategies for applying these multidimensional indices, including the development of a “function-imaging-symptom” phenotyping model, a combined scoring system for prognostic assessment, and pathways for clinical translation.
文章引用：唐林琳, 江宇. 超越FEV1：多维肺功能指标在COPD精细评估与预后判断中的整合应用[J]. 临床医学进展, 2025, 15(12): 1707-1715. https://doi.org/10.12677/acm.2025.15123584

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