go to our full topic on 急性 COPD 加重
COPD的急性加重可以很轻,也可以非常严重甚至威胁生命,常由细菌或者病毒感染、污染物或者温度和湿度改变引发。 为急性发病,且患者的呼吸系统症状、肺功能、功能状态和生活质量持续恶化。[3]Rodriguez-Roisin R. COPD exacerbations. 5: management. Thorax. 2006 Jun;61(6):535-44.
http://www.ncbi.nlm.nih.gov/pubmed/16738044?tool=bestpractice.com
[4]Cote CG, Dordelly LJ, Celli BR. Impact of COPD exacerbations on patient-centered outcomes. Chest. 2007;131:696-704.
http://www.ncbi.nlm.nih.gov/pubmed/17356082?tool=bestpractice.com
[5]O'Donnell DE, Parker CM. COPD exacerbations. 3: Pathophysiology. Thorax. 2006;61:354-361.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2104611
http://www.ncbi.nlm.nih.gov/pubmed/16565268?tool=bestpractice.com
[6]Spencer S, Jones PW; GLOBE Study Group. Time course of recovery of health status following an infective exacerbation of chronic bronchitis. Thorax. 2003;58:589-593.
http://thorax.bmj.com/content/58/7/589.long
http://www.ncbi.nlm.nih.gov/pubmed/12832673?tool=bestpractice.com
[7]Xu W, Collet JP, Shapiro S, et al. Negative impacts of unreported COPD exacerbations on health-related quality of life at 1 year. Eur Respir J. 2010;35:1022-1030.
http://erj.ersjournals.com/content/35/5/1022.long
http://www.ncbi.nlm.nih.gov/pubmed/19897555?tool=bestpractice.com
随着 COPD 的进展,急性加重会变得更频繁、更严重,[8]Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003 Jun;41:46s-53s.
https://erj.ersjournals.com/content/21/41_suppl/46s.long
http://www.ncbi.nlm.nih.gov/pubmed/12795331?tool=bestpractice.com
[9]Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363:1128-1138.
http://www.nejm.org/doi/full/10.1056/NEJMoa0909883
http://www.ncbi.nlm.nih.gov/pubmed/20843247?tool=bestpractice.com
其本身可能加速 COPD 的病情发展。[10]Donaldson GC, Seemungal TA, Bhowmik A, et al. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002 Oct;57(10):847-52.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746193
http://www.ncbi.nlm.nih.gov/pubmed/12324669?tool=bestpractice.com
除了 COPD 的常规治疗方法外,已发现抗生素对治疗急性加重的病情有益,[11]Llor C, Moragas A, Hernández S, et al. Efficacy of antibiotic therapy for acute exacerbations of mild to moderate chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186:716-723.
http://www.atsjournals.org/doi/full/10.1164/rccm.201206-0996OC#.VMI333s9VSo
http://www.ncbi.nlm.nih.gov/pubmed/22923662?tool=bestpractice.com
推荐在怀疑由细菌引发疾病的患者中使用。[3]Rodriguez-Roisin R. COPD exacerbations. 5: management. Thorax. 2006 Jun;61(6):535-44.
http://www.ncbi.nlm.nih.gov/pubmed/16738044?tool=bestpractice.com