对于所有心肺疾病(包括慢阻肺)患者,强烈推荐接种流感疫苗和肺炎链球菌疫苗。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2021 [internet publication].
https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
[129]Walters JA, Tang JN, Poole P, et al. Pneumococcal vaccines for preventing pneumonia in chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2017 Jan 24;(1):CD001390.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001390.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/28116747?tool=bestpractice.com
[131]Centers for Disease Control and Prevention. Pneumococcal vaccination: summary of who and when to vaccinate. November 2019 [internet publication].
https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html
对维生素 D 水平 <25 nmol/L 的患者补充维生素 D,可降低中度/重度加重发生率。[189]Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax. 2019 Apr;74(4):337-45.
https://www.doi.org/10.1136/thoraxjnl-2018-212092
http://www.ncbi.nlm.nih.gov/pubmed/30630893?tool=bestpractice.com
对于 COPD 加重的住院患者,应检查维生素 D 水平,如果 <25 nmol/L,应进行补充。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2021 [internet publication].
https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
对于部分患者,可能需要补充钙和使用其他药物预防或治疗骨质疏松症,特别是长期接受皮质类固醇治疗的老年女性。为评估这种疾病的进展,可进行骨密度扫描。
对于所有慢阻肺患者推荐进行体育活动。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2021 [internet publication].
https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf