COPD诊断与治疗（修订版）.pptVIP

* * 3．胸部CT检查：。 * * MedicationsMedications can be used to relieve symptoms of COPD, particularly shortness of breath, and to treat respiratory tract infections that can worsen COPD.[19] Currently available medications that are helpful in treating COPD include bronchodilators and corticosteroids. Antibiotics are useful in treating exacerbations caused by bacterial infections. No medications have been found to cure the disease or reverse the loss of lung function caused by smoking.[8] Medications of different classes have been found to be useful in treating COPD and can be used in combination. The overall approach to managing stable COPD involves a stepwise increase in treatment, depending on the severity of the disease.[19] * Bronchodilators are a class of medications that relax the muscles around the bronchi to allow easier breathing. They are typically indicated for the relief of bronchospasm, which are contractions of the smooth muscle in the walls of the bronchi and bronchioles that cause the airways to constrict or narrow.[8] Anticholinergic bronchodilators fall into this class of COPD medications, as do short-acting beta2-agonists, long-acting beta2- agonists, methylxanthines (e.g., theophylline), and a combination of an anticholinergic bronchodilator and a short-acting beta2-agonist. All major guidelines for COPD management recommend beginning treatment with aerosol bronchodilators, which are inhaled directly into the lungs and have few side effects.[18,19,21,22] * * Anticholinergic bronchodilatorsIn response to irritants such as cigarette smoke, the body produces a chemical messenger called acetylcholine that induces the airways to constrict. Anticholinergics are the only medications that act by blocking acetylcholine, thereby relaxing the muscle tissue and keeping the airways open.[24] Anticholinergic medications work via part of the parasympathetic nervous system, which controls airway size. In addition to helping COPD patients take fuller breaths