小结
定义
病史和体格检查
其他诊断因素
- past medical history of COPD
- tobacco dependence
- past medical history of gastroesophageal reflux/swallowing dysfunction
- malaise and fatigue
- chest tightness
- features of cor pulmonale
- environmental/occupational exposure to pollutants or dust
- change in mental status
- fever
- accessory muscle use
- paradoxical movements of abdomen
诊断性检查
治疗流程
撰稿人
专家顾问
Carolyn L. Rochester, MD
Professor of Medicine
Yale School of Medicine
New Haven
VA Connecticut Healthcare System
West Haven, CT
利益声明
CLR serves on the COPD scientific advisory board for GlaxoSmithKline Pharmaceuticals but has no competing interests pertaining to this publication.
Richard A. Martinello, MD
Associate Professor
Yale School of Medicine
New Haven, CT
利益声明
RAM declares that he has no competing interests.
同行评议者
Antonio Anzueto, MD
Professor of Medicine
University of Texas Health
Section Chief
South Texas Veterans Health Care System
San Antonio, TX
利益声明
AA has been a consultant for GlaxoSmithKline, AstraZeneca, Boehringer-Ingelheim, Theravance and Grifols. AA has been reimbursed for his services by these companies. AA is a member of the GOLD scientific committee.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
专家顾问：合并症
Pankaj Shah, MD
Endocrinologist
Assistant Professor of Medicine
Department of Internal Medicine
Chair, Hospital Diabetes and Endocrinology Core Group
Mayo Clinic
Rochester, MN
利益声明
As part of his job at his institute, PS provides expert opinion in a physician education tool called "Ask Mayo Expert", where he is one of several "Subject Matter Experts." He also addresses academic educational activities in the US and abroad as part of his institutional duty. PS declares no other competing interests.
Preethi Pirlamarla, MD
Physician (Cardiologist)
Director of Quality Improvement for the Advanced Heart Failure and Cardiac Transplant Department
Heart Institute at University of Washington Medical Center - Montlake
Seattle, WA
利益声明
PP declares that she has no competing interests.
Lorenzo Azzalini, MD, PhD, MSc, FACC, FSCAI
Associate Professor of Medicine
Division of Cardiology
Department of Medicine
University of Washington
Director of Interventional Cardiology Research, Heart Institute at University of Washington Medical Center - Montlake
Seattle, WA
利益声明
LA has received consulting fees from Teleflex, Abiomed, GE Healthcare, Reflow Medical, Shockwave Medical, Boston Scientific, XyloCor Therapeutics, and HeartFlow; and owns equity in Reflow Medical.
Philip R. Muskin, MD, MA, DLFAPA, LFACLP
Professor of Psychiatry
Columbia University Irving Medical Center
Senior Consultant in Consultation-Liaison Psychiatry
New York-Presbyterian/Columbia University Irving Medical Center
New York, NY
利益声明
PRM is an Associate Editor of American Psychiatric Association Publishing and on the editorial board for the journal Focus, for which he receives no compensation. At the American Board of Psychiatry and Neurology he is a member of the Article Based Certification Committee for Consultation-Liaison Psychiatry (no compensation), and at the American Psychiatric Association he is a member of the Scientific Program Committee for the Annual Meeting 2025 (no compensation) and will be on this committee in 2026. PRM serves as an expert witness in psychiatric malpractice lawsuits, for which he is compensated. He was grant co-investigator for the proposal “Can hypnosis enhance the ability to regulate behavioral and brain markers of emotion regulation?” (Proposal No. 75037-NS, Department of the Army, US Army Combat Capabilities Development Command, Army Research Office), which ended in 2023. PRM receives royalties from American Psychiatric Association Publishing for The American Psychiatric Publishing Study Guide for the Psychiatry Board Examination (edited by Muskin PR and Dickerman AL, American Psychiatric Publishing, 2016), and makes presentations at the American Psychiatric Association and Academy of Consultation-Liaison Psychiatry Annual Meetings.
Seki Balogun, MD, FACP, AGSF
Professor of Medicine
Geriatrician and Palliative Care Physician
University of Oklahoma Health Sciences Center
Oklahoma City, OK
利益声明
SB serves on the United States Medical Licensing Examination (USMLE) Step 3 Interdisciplinary Review Committee.
Khalilah Gates, MD
Associate Professor of Medicine (Pulmonary and Critical Care)
Assistant Dean of Learning and Academic Performance
Division of Pulmonary and Critical Care
Department of Medicine
Northwestern University Feinberg School of Medicine
Medical Director, Diversity and Inclusion Education
NM Academy
Chicago, IL
利益声明
KG is a Board Member of the Respiratory Health Association, where she focuses on communication for COPD and asthma and has no financial agreements or obligations.
Karen Jubanyik, MD
Associate Professor of Emergency Medicine
Director
Emergency Medicine Clerkship
Yale School of Medicine
New Haven, CT
利益声明
KJ declares that she has no competing interests.
Madeleine Alexeeva, DO
Emergency Medicine Physician
Vituity
Visalia, CA
Associate Program Director of Emergency Medicine Residency
Kaweah Health Medical Center
Visalia, CA
利益声明
MA declares that she has no competing interests.
Lindsey Phillips, MD
Clinical Associate Professor of Medicine
University of North Carolina School of Medicine
Chapel Hill, NC
利益声明
LP declares that she has no competing interests.
Michael S. Phipps, MD, MHS
Associate Professor of Neurology and Epidemiology and Public Health
University of Maryland School of Medicine
Director of the Brain Attack Center at the University of Maryland Medical Center
Baltimore, MD
利益声明
MSP declares that he is a Liaison, American Heart Association, QCOR Committee (non-financial). No financial disclosures.
Lourdes (Maria) Gonzalez Suarez, MD, PhD
Assistant Professor of Medicine
Assistant Program Director
Nephrology Fellowship
Clinical director
Chronic Kidney Disease Clinic
Mayo Clinic
Rochester, MN
利益声明
MLGS has been a member of Alexion advisory board, and contractual research (site principal investigator) with AstraZeneca and Parexel.
Acknowledgement: Ziad Zoghby
BMJ Best Practice would like to gratefully acknowledge Ziad Zoghby for his previous role as expert adviser for the nephrology information in the Comorbidities Manager.
Ziad Zoghby MD, MBA, FACP
Associate Professor of Medicine
Division of Nephrology and Hypertension
Department of Medicine
Mayo Clinic
Rochester, MN
利益声明
ZZ received fees for consultancy work in 2022 and 2023 for ChroniSense Ltd, a remote digital health company. He has served since 2018 on the Nephrology Specialty Board for EPIC, an electronic health record vendor, and is the elected Chair of the Board for 2024-2025 (a nonpaid position).
参考文献
关键文献
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis and management of COPD: 2025 report. 2025 [internet publication].全文
Stevermer JJ, Fisher L, Lin KW, et al. Pharmacologic management of COPD exacerbations: a clinical practice guideline from the AAFP. Am Fam Physician. 2021 Jul 1;104(1):Online.全文 摘要
Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64. 摘要
参考文献
A full list of sources referenced in this topic is available here.
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