COPD exacerbations: defining their cause and prevention.
COPD exacerbations: defining their cause and prevention.
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DOI：
10.1016/s0140-6736(07)61382-8
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发表时间：
2007-09-01
期刊：
影响因子：
--
通讯作者：
Seemungal TA
中科院分区：
文献类型：
--
作者：
Wedzicha JA;Seemungal TA
慢性阻塞性肺疾病(COPD)的加重是症状恶化的发作，导致相当大的发病率和死亡率。慢性阻塞性肺疾病的加重与呼吸道和全身炎症及生理变化，特别是恶性充气的发展有关。它们主要由呼吸道病毒和细菌触发，这些病毒和细菌感染下呼吸道，增加呼吸道炎症。一些患者特别容易恶化，与那些不经常恶化的患者相比，他们的健康状况更差，疾病进展更快。几种药物干预措施对于减少COPD的恶化频率和严重程度是有效的，例如吸入类固醇、长效支气管扩张剂及其组合。非药物疗法，如肺康复、自我管理和家庭呼吸机支持正变得越来越重要，但仍需要在对照试验中进行研究。恶化预防的未来是评估药物和非药物治疗的最佳组合，这将导致改善健康状况，减少住院和与COPD相关的死亡率。
Exacerbations of chronic obstructive pulmonary disease (COPD) are episodes of worsening of symptoms, leading to substantial morbidity and mortality. COPD exacerbations are associated with increased airway and systemic inflammation and physiological changes, especially the development of hyperinflation. They are triggered mainly by respiratory viruses and bacteria, which infect the lower airway and increase airway inflammation. Some patients are particularly susceptible to exacerbations, and show worse health status and faster disease progression than those who have infrequent exacerbations. Several pharmacological interventions are effective for the reduction of exacerbation frequency and severity in COPD such as inhaled steroids, long-acting bronchodilators, and their combinations. Non-pharmacological therapies such as pulmonary rehabilitation, self-management, and home ventilatory support are becoming increasingly important, but still need to be studied in controlled trials. The future of exacerbation prevention is in assessment of optimum combinations of pharmacological and non-pharmacological therapies that will result in improvement of health status, and reduction of hospital admission and mortality associated with COPD.