【优质】COPD2015诊治新指南.pptVIP

The guideline of COPD How to treat COPD? 1.Access and Monitor Desease 2.Reduce Risk Factors 3.Manage stable COPD 4.Manage Exacerbation Access and Monitor Desease Symtoms: Chronic cough , Sputum ， dyspnea et. Spirmetry (gold standard): (post bronchodilator ) FEV1/FVC〈70% COPD分期与分级 Thank you！ Reduce Risk Factors Manage stable COPD Manage stable COPD Manage stable COPD Manage stable COPD Manage stable COPD Manage stable COPD Manage stable COPD 大医精诚 尚美至善 DEFINITION OF COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) WHO/NHLBI Initiative 2010 “COPD is a disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases” “COPD is a disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases” Barnes PJ. N Engl J Med 2000;343:269 INFLAMMATION Small airway disease Airway inflammation Airway remodeling Parenchymal destruction Loss of alveolar attachments Decrease of elastic recall AIRFLOW LIMITATION Recommnedation 1 Spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms(strong recommendation /moderatequality evidence) Spirometry should not be used to screen for airflow obstruction in patients without respiratory symptoms (strong recommendation /moderatequality evidence) Recommnedation 2 For stable COPD patients with respiratory symptoms and FEV1 between 60% and 80% predicted，ACP、ACCP、ATS、and ERS suggest that treatment with inhaled bronchodialators may be used。（weak recommendation /low-quality evidence) Recommnedation 3 For stable COPD patients with respiratory symptoms and FEV1 ﹤60% predicted，ACP、ACCP