课件：慢阻肺急性加重诊断和治疗新进展蔡柏蔷.ppt

谢 谢！ THANK YOU SUCCESS * * 可编辑 Bray-Curtis Dissimilarity：bray-curtis聚类分析差异度，是反应两个群落差异性最常用的指标。 B-C差异度等于0 ：两个群落具有完全相同的构成 (i.e., share all species), B-C差异度等于1：群落间do not share any species. There is a significant difference between the bacterial communities on Day 15 in the subjects with chronic obstructive pulmonary disease (COPD) compared with the baseline community. *P , 0.001 (two-tailed t test). * Conclusions： After rhinovirus infection, there is a rise in bacterial burden and a significant outgrowth of Haemophilus influenzae from the existing microbiota of subjects with COPD. This is not observed in healthy individuals. Our findings suggest that rhinovirus infection in COPD alters the respiratory microbiome and may precipitate secondary bacterial infections * 均为各大城市的综合性三甲医院，地域跨度较大 * 2007年-2008年在全国进行的一项多中心问卷调查显示，近2/3的中国稳定期慢阻肺患者FEV1≤50%，属于C/D级。 * * 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 rol