COPD (Definition, clinical manifestations, diagnosis, and ：慢性阻塞性肺疾病（定义，临床表现，诊断，和精品.docxVIP

COPD (Definition, clinical manifestations, diagnosis, and staging)INTRODUCTIONCOPD is a common respiratory condition involving the airways and characterized by airflow limitation. It affects 5% of population and is associated with high morbidity and mortality. It is 3rd-ranked cause of death in the US, killing 120,000 individuals each year. As consequence of its high prevalence and chronicity, COPD causes high resource utilization with frequent clinician office visits, frequent hospitalizations due to acute exacerbations, and the need for chronic therapy (supplemental O2 therapy, medication).Correct diagnosis of COPD is important because appropriate management can decrease symptoms (especially dyspnea), reduce the frequency and severity of exacerbations, improve health status, improve exercise capacity, and prolong survival.The definition, clinical manifestations, diagnostic evaluation, and staging of COPD are discussed in this topic review. The risk factors, natural history, prognosis, and treatment of COPD are discussed separately.DEFINITIONSThe definition of COPD and its subtypes (emphysema, chronic bronchitis, chronic obstructive asthma) and interrelationships between closely related disorders that cause airflow limitation provide foundation for understanding spectrum of patient presentations.COPDThe GOLD – project initiated by National Heart, Lung, and Blood Institute (NHLBI) and WHO defines COPD as common preventable and treatable disease, is characterized by airflow limitationthat is usually progressive and associated with enhanced chronic inflammatory response in airways and lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients.Chronic bronchitisChronic bronchitis is defined aschronic productive cough for 3 months in each of 2 successive yearsin patient in whom other causes of chronic cough (bronchiectasis) have been excluded. It may precede or follow development of airflow limitation.