慢性阻塞性肺疾病（chronicobstructivepulmonarydisease）课件.pptVIP

Clinical COPD Questionnaire(CCQ)临床COPD问卷 The Clinical COPD Questionnaire is a self-administered questionnaire specially developed to measure clinical control in patients with COPD. Date support the validity, reliability and responsiveness of this short and easy to administer questionnaire. Further research is needed to validated discriminative performance and practical implications of the CCQ in detecting excerbations in daily care. Based on current knowledge. a cut of 0-1 CCQ could be considered for Patient Group A and C; a CCQ ≥1 could be considered for Patient Groups B and D. Association Between Symptoms,Spirometric Classification,and Future Risk of Exacerbations（When assessing risk, choose the highest riskaccording to GOLD grade or exacerbation history） 气 流 受 限 危 的 G 险 O L D 分 类 加 重 危 的 险 病 史 （C） （D） （A） （B） 4 3 2 1 ≥2 1 0 mMRC 0-1 mMRC ≥2 CAT 10 CAT ≥ 10 症状（mMRC 或 CAT 分值） COPD2013年指南患者复合评估表 分组 临床特征 GOLD分级 发作频率/年 mMRC CAT A 低危，较少症状 GOLD 1-2 ≤ 1 0-1 10 B 低危，较多症状 GOLD 1-2 ≤ 1 ≥ 2 ≥ 10 C 高危，较少症状 GOLD 3-4 ≥ 2 0-1 10 D 高危，较多症状 GOLD 3-4 ≥ 2 ≥ 2 ≥ 10 Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease ( Updated 2013） 注： CAT系COPD评估测试，mMRC系呼吸困难指数评分 7. COPD 的鉴别诊断 COPD的鉴别诊断（1） Diagnosis Suggestive Features COPD Onset in mid-life. Symptoms slowly progressive. History of tobacco smoking or exposure to other types of smoke. Asthma Onset early in life (often childhood). Symptoms vary widely from day to day. Symptoms worse at night/early morning. Allergy, rhinitis, and/or eczema also present. Family history of asthma. Congestive Heart Failure