慢阻肺急性加重诊断和治疗新进展-蔡柏蔷.ppt

* Vestbo J. What is an exacerbation of COPD? European Respiratory Review 2004;13:6–13 Synopsis: This review explores the different ways in which exacerbations of COPD are defined and examines the aetiology of these events and the burden they impose on patients and society in terms of morbidity, mortality, HRQL and costs. The impact of ICS and ICS/LABA combinations, including Symbicort, on exacerbations and related outcomes are discussed. Published abstract: Patients with chronic obstructive pulmonary disease (COPD) experience acute exacerbations that increase in frequency with disease severity. Exacerbations may be defined in various ways, depending on the needs of researchers, clinicians, patients or healthcare payers. At present, action-based definitions (based on the need for treatment with oral corticosteroids, antibiotics, or both, and/or hospitalisation due to respiratory symptoms) are the best available for the purposes of comparing medical treatments that may reduce or prevent exacerbations. Further research is required to elucidate the mechanisms underlying COPD exacerbations, including the possible role of eosinophils. Exacerbations of COPD accelerate lung function decline, increase the risk of hospitalisation and death, cause sustained impairment of health status, and generate substantial socio-economic costs. Combination therapy with inhaled corticosteroids and long-acting β2-agonists reduces the frequency of exacerbations, in addition to improving lung function, symptoms and health status and, possibly, lowering the risk of mortality. In summary, a greater awareness of the pathogenesis of exacerbations and their impact is necessary to encourage optimal treatment. Interventions that effectively prevent or treat exacerbations, such as inhaled corticosteroids/long-acting β2-agonists combination therapy, have the potential to significantly reduce the impact of chronic obstructive pulmonary disease on patients and society. This material has been supplied