谭copd量慢性支气管炎.ppt

* 前面提到，COPD发病与肺部对有害颗粒或气体的异常炎症反应有关，并伴有显著的肺外效应 其肺外效应与患者疾病的严重性相关。从这张图我们可以看出，COPD患者体内可以发生全身炎症反应，从而导致多个靶器官受累，包括肌肉、骨骼、心脏等。 * 随着年龄的增加，COPD的发病率呈现上升趋势，这是不可干预的因素，但研究发现，。。。。。。等是可干预因素，重在早发现，可以阻断或延缓疾病的发展。 * . * Exacerbations of COPD are a major cause of morbidity, mortality and hospital admission.1,2 Some patients are particularly susceptible to developing frequent exacerbations, an important determinant in health-related quality of life.1–3 The downward spiral of more frequent exacerbations can lead to decline in lung function; greater anxiety; worsening quality of life; social withdrawal; more exacerbations and increased risk of hospitalisation.1-9 As frequent exacerbations are associated with a faster long-term decline in lung function, it has also been suggested that prevention of exacerbations might slow disease progression.9 In addition, a reduction in the frequency or severity of exacerbations offers an obvious means of reducing demand on the healthcare system. Patients who are prone to exacerbations have been found to have higher airway cytokine levels suggesting increased airway inflammation that could increase susceptibility to exacerbation.5 These patients are also prone to larger falls in FEV1 at exacerbations, prolonged and more frequent hospital admissions, more chronic respiratory symptoms and more severe exacerbations.4 Exacerbations that require hospital admission are associated with a high risk of mortality 10. References: 1. Rodriguez-Roisin R. Towards a consensus definition for COPD exacerbations. Chest 2000; 117: 398S–401S. 2. Wedzicha JA. Mechanisms of exacerbations. Novart Found Symp 2001; 234: 84–103. 3. Seemungal TAR, Donaldson GC, Paul EA et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 1418–22. 4. Garcia-Aymerich J, Monso E, Marrades RM et al. Risk factors for hospitalisation for a chronic obstructive pulmonary disease excerbation - EFRAM study. Am J Resp