根据当地指南,患者应接种流感病毒疫苗、肺炎链球菌疫苗、百日咳疫苗、水痘-带状疱疹病毒疫苗和 2019 冠状病毒病(coronavirus disease 2019, COVID-19)疫苗。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [internet publication].
https://goldcopd.org/2023-gold-report-2
[168]Centers for Disease Control and Prevention. Lung disease including asthma and adult vaccination. Feb 2021 [internet publication].
https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/lung-disease.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。[250]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
[251]Li X, He J, Yu M, et al. The efficacy of vitamin D therapy for patients with COPD: a meta-analysis of randomized controlled trials. Ann Palliat Med. 2020 Mar;9(2):286-97.
https://www.doi.org/10.21037/apm.2020.02.26
http://www.ncbi.nlm.nih.gov/pubmed/32156131?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: 2023 report [internet publication].
https://goldcopd.org/2023-gold-report-2
冬季可考虑采取屏蔽保护措施(例如佩戴口罩、尽量减少社交接触和经常洗手),同时建立 COPD 管理,从而帮助预防 COPD 急性加重。[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [internet publication].
https://goldcopd.org/2023-gold-report-2
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COPD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: 2023 report [internet publication].
https://goldcopd.org/2023-gold-report-2