Dyspnoea, “the subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity” [1], is ever present in patients with chronic obstructive pulmonary disease (COPD) and affects almost all aspects of their daily lives [2]: up 60% of patients have limitations in normal physical activity and more than a third are restricted in family activities [2]. Dyspnoea is usually the earliest and most troublesome complaint for which these patients seek medical attention. As the underlying disease advances, dyspnoea progresses relentlessly, invariably leading to a gradual decrease in activity levels and associated skeletal muscle deconditioning and impoverished quality of life [2]. Dyspnoea also has strong prognostic value for mortality: stronger than the forced expiratory volume in 1 s in patients with COPD or angina in patients with heart disease [3, 4]. Opioids show promise in managing exertional dyspnoea; safety of widespread use in COPD patients remains unproven http://ow.ly/A9bX30fr7FR

中文翻译：

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吗啡缓解 COPD 劳力性呼吸困难：神话、梦想还是现实？

呼吸困难，“呼吸不适的主观体验，包括强度不同的质量上不同的感觉”[1]，慢性阻塞性肺病 (COPD) 患者一直存在，几乎影响他们日常生活的所有方面 [2]：多达 60% 的患者在正常体力活动方面受到限制，超过三分之一的患者在家庭活动方面受到限制[2]。呼吸困难通常是这些患者就医的最早和最麻烦的主诉。随着潜在疾病的进展，呼吸困难会不断恶化，总是会导致活动水平逐渐下降，并导致相关的骨骼肌失调和生活质量下降 [2]。呼吸困难对死亡率也有很强的预后价值：强于 COPD 患者或心脏病患者心绞痛 1 s 内用力呼气量 [3, 4]。阿片类药物在控制劳力性呼吸困难方面显示出前景；在 COPD 患者中广泛使用的安全性尚未得到证实 http://ow.ly/A9bX30fr7FR