慢性病防治课件幻灯片.ppt

谢谢 电话 每周六专家门诊 * * 因AECOPD而导致的死亡率非常高。国外数据显示，AECOPD导致死亡在ICU中为24％；对于年龄大于65岁的患者，其死亡率更达到了30％。AECOPD的高死亡率使及时治疗显得更为重要。 * * COPD急性加重是导致发病、死亡及住院的主要原因1,2。一些患者特别易发COPD急性加重，是健康相关生活质量的重要决定因素1–3 频繁发作的急性加重导致肺功能下降；极度焦虑；生活质量变差；与社会脱节；COPD的进一步加重以及住院危险增加1-9 由于频发的急性加重与肺功能快速衰退密切相关，因此预防急性加重或许能够延缓疾病的进展9。此外，急性加重的发作次数或严重程度为医疗系统提供了一个明显的指标。 研究显示，急性加重易发的患者的气道细胞因子水平较高，提示气道炎症增加导致急性加重发生的易感性升高5 急性加重时，这些患者也更易发生FEV1进一步下降，住院次数增多，住院时间延长，慢性呼吸道症状增多以及更严重的COPD急性加重4 。需要住院治疗的急性加重与死亡的高危险性呈正相关10 References: 1. Rodriguez-Roisin R. Towards a consensus definition for COPD exacerbations. Chest 2000; 117: 398S–401S. 2. Wedzicha JA. Mechanisms of exacerbations. Novart Found Symp 2001; 234: 84–103. 3. Seemungal TAR, Donaldson GC, Paul EA et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 1418–22. 4. Garcia-Aymerich J, Monso E, Marrades RM et al. Risk factors for hospitalisation for a chronic obstructive pulmonary disease exacerbation - EFRAM study. Am J Respir Crit Care Med 2001; 164: 1002–07. 5. Donaldson GC, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57(10): 847–52. 6. Gore JM, Brophy CJ, Greenstone MA. How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer. Thorax 2000; 55: 1000–6. 7. Pauwels RA, Buist AS, Calverley PM et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001; 163: 1256–76. 8. Seemungal TA, Donaldson GC, Bhowmik A et al. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000; 161: 1608–13. 9. Garcia-Aymeri