Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society
Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society
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DOI：
10.7326/0003-4819-155-3-201108020-00008
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发表时间：
2011-08-02
影响因子：
39.2
通讯作者：
Shekelle, Paul
中科院分区：
文献类型：
--
作者：
Qaseem, Amir;Wilt, Timothy J.;Shekelle, Paul
说明：本指南是美国内科医师学会 (ACP)、美国胸科医师学会 (ACCP)、美国胸科学会 (ATS) 和欧洲呼吸学会 (ERS) 的官方声明。它代表了 2007 年 ACP 关于稳定型慢性阻塞性肺疾病 (COPD) 诊断和管理的临床实践指南的更新，适用于管理 COPD 患者的临床医生。本指南阐述了病史和体格检查对于预测气流阻塞的价值；肺活量测定法对于慢性阻塞性肺病筛查或诊断的价值；方法：本指南基于 2007 年 3 月至 2009 年 12 月的有针对性的文献更新，以评估证据并更新 2007 年 ACP 稳定型慢性阻塞性肺疾病诊断和管理临床实践指南 COPD。建议1：ACP、ACCP、ATS和ERS建议应进行肺活量测定来诊断有呼吸道症状的患者的气流阻塞（等级：强烈推荐，中等质量证据）。肺活量测定不应用于无呼吸道症状的个体中筛查气流阻塞（等级：强烈推荐，中等质量证据）。建议2：对于有呼吸道症状且FEV1在预测值60%至80%之间的稳定COPD患者，ACP、ACCP、ATS和ERS建议可使用吸入性支气管扩张剂治疗（等级：弱推荐，低质量证据）。建议 3：对于有呼吸道症状和FEV1的稳定COPD患者
Description: This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable chronic obstructive pulmonary disease (COPD) and is intended for clinicians who manage patients with COPD. This guideline addresses the value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies (anticholinergics, long-acting beta-agonists, and corticosteroids), pulmonary rehabilitation programs, and supplemental oxygen therapy.Methods: This guideline is based on a targeted literature update from March 2007 to December 2009 to evaluate the evidence and update the 2007 ACP clinical practice guideline on diagnosis and management of stable COPD.Recommendation 1: ACP, ACCP, ATS, and ERS recommend that spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms (Grade: strong recommendation, moderate-quality evidence).Recommendation 2: For stable COPD patients with respiratory symptoms and FEV1 between 60% and 80% predicted, ACP, ACCP, ATS, and ERS suggest that treatment with inhaled bronchodilators may be used (Grade: weak recommendation, low-quality evidence).Recommendation 3: For stable COPD patients with respiratory symptoms and FEV1