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1 Introduction Chronic obstructive pulmonary disease (COPD) is the third cause of death in the world, characterized by high morbidity and mortality, and has become a major disease burden worldwide ( 2 Pathology of COPD The two main pathological types of COPD are small airway disease due to fibrosis around the bronchioles and emphysema due to destruction of the alveolar walls, which can be distinguished by computed tomography (CT) examination