Acute exacerbation of chronic obstructive pulmonary disease:Update_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIU Chuntao , FENG Yulin

Department of Respiratory Medicine, West China Hospital, Sichuan University. Chengdu, Sichuan, 610041, China;

Corresponding?author：

Keywords：

慢性阻塞性肺疾病; 急性加重; 研究進展

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根據慢性阻塞性肺疾病全球創議(GOLD)的定義，慢性阻塞性肺疾病急性加重(AECOPD)是“在COPD的自然病程中發生的事件，氣緊、咳嗽或／和咳痰等基礎癥狀加重超出正常的日間變異的范圍，急性發病，可能需要改變常規的治療”[1]。AECOPD意味著對醫療衛生資源耗用的增加，如非預約的就醫、使用藥物增加，使用抗生素或口服皮質激素甚至住院，等等。僅僅依據是否占用衛生資源來定義AECOPD并不適當，這一點還要取決于醫療衛生資源的可獲得性，同時有研究提示部分AECOPD可以是自限性的，特別是輕度急性加重。另一方面，占用醫療衛生資源的形式可以大致評估AECOPD的嚴重程度，如需要增加常規的吸人性藥物常常意味著輕度AECOPD，需要短程口服抗生素或糖皮質激素意味著中度AECOPD，而需要住院者多為重度AECOPD。AECOPD是導致COPD患者健康狀態降低乃至死亡的主要原因，也是耗用醫療衛生資源從而構成COPD疾病負擔的主要部分，需要采用有力的干預措施以降低其發生率[2]。

Citation： LIU Chuntao,FENG Yulin. Acute exacerbation of chronic obstructive pulmonary disease:Update. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(6): 413-415. doi: Copy

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6.	Hurst JR，Wilkinson TM，Perera WR，et al.Relationships among bacteria，upper airway，lower airway，and systemic inflammation in COPD.Chest，2005，127：1219-1226.
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8.	Calverley PM，Anderson JA，Celli B，et al.Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.N Engl J Med，2007，356：775-789.
9.	Calverley PM，Boonsawat W，Cseke Z，et al.Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease.Eur Respir J，2003，22：912-919.
10.	Casanova C，Celli BR，Tost L，et al.Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD.Chest，2000，118：1582-1590.

1. Rabe KF，Hurd S，Anzueto A，et al.Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：GOLD executive summary.Am J Respir Crit Care Med，2007，176：532-555.
2. Seemungal TA，Donaldson GC，Bhowmik A，et al.Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2000，161：1608-1613.
3. O’Donnell DE，Parker CM.COPD exacerbations 3：Pathophysiology.Thorax，2006，61：354-361.
4. Perera WR，Hurst JR，Wilkinson TM，et al.Inflammatory changes，recovery and recurrence at COPD exacerbation.Eur Respir J，2007，29：527-534.
5. Seemungal T，Harper-Owen R，Bhowmik A，et al.Respiratory viruses，symptoms，and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2001，164：1618-1623.
6. Hurst JR，Wilkinson TM，Perera WR，et al.Relationships among bacteria，upper airway，lower airway，and systemic inflammation in COPD.Chest，2005，127：1219-1226.
7. Ram FSF，Rodriguez-Roisin R，Granado-Navarrete A，et al.Antibiotics for exacerbation of chronic obstructive pulmonary disease.Cochrane Database Syst Rev，2006，2：CD004403.
8. Calverley PM，Anderson JA，Celli B，et al.Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.N Engl J Med，2007，356：775-789.
9. Calverley PM，Boonsawat W，Cseke Z，et al.Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease.Eur Respir J，2003，22：912-919.
10. Casanova C，Celli BR，Tost L，et al.Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD.Chest，2000，118：1582-1590.

Chinese Journal of Respiratory and Critical Care Medicine

Acute exacerbation of chronic obstructive pulmonary disease:Update

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