Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline from the American college of physicians
Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline from the American college of physicians
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DOI：
10.7326/0003-4819-147-9-200711060-00008
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发表时间：
2007-11-06
影响因子：
39.2
通讯作者：
Owens, Douglas K.
中科院分区：
文献类型：
--
作者：
Qaseem, Amir;Snow, Vincenza;Owens, Douglas K.
建议1：对于有呼吸道症状，特别是呼吸困难的患者，应进行肺活量测定来诊断气流阻塞。肺活量测定法不应用于筛查无症状个体的气流阻塞。（等级：强烈推荐，证据质量中等）建议2：稳定期慢性阻塞性肺疾病（COPD）的治疗应保留给有呼吸道症状且肺活量测定法记录的FEV1小于预测值60%的患者。（等级：强烈推荐，证据质量中等）建议3：对于有症状且FEV1小于预测值60%的COPD患者，临床医生应开出以下1种维持单药：长效吸入β受体激动剂、长效吸入抗胆碱能药或吸入皮质类固醇。（等级：强烈推荐，高质量证据）建议4：对于有症状且FEV1低于预期60%的COPD患者，临床医生可考虑联合吸入治疗。（等级：弱推荐，证据质量中等）建议5：临床医生应为COPD伴静息性低氧血症患者开氧治疗（Pao(2)）
Recommendation 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.)Recommendation 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.)Recommendation 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.)Recommendation 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.)Recommendation 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao(2)