英文精品课件chronic obstructive pulmonary disease （35p）

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1、CHRONICOBSTRUCTIVEPULMONARYDISEASECLINICALPRACTICEGUIDELINESREVIEWWEEK1:DIAGNOSISAMBULATORYINTERNALMEDICINEGROUPPRACTICEUNIVERSITYHEALTHNETWORK/MSHSEPTEMBER2007Preparedby:Dr.D.PaniskoCOPD:GuidelinesforthisSeminarStandardsforthediagnosisandtreatmentofpatientswithCOPD:asummaryoftheATS/

2、ERSpositionpaper.CelliBRetal.EurRespirJ2004;23:932-46.Fulldocument,withupdates,availableat:www.thoracic.org,accessedSept2007CanadianThoracicSocietyrecommendationsforthemanagementofchronicobstructivepulmonarydisease-2003.O’DonnellDEetal.CanRespirJ2003;10(SupplA):11A-33AGlobalInitiative

3、forChronicObstructiveLungDisease.(GOLD).AcollaborativeoftheNIHandWHO.UpdatedNov2006,accessedSept2007.Availableatwww.goldcopd.comCOPDDiagnosis:ObjectivesAfterthisseminaryoushould:beawareofdiagnosticclinicalpracticeguidelinesforstablechronicCOPDbeabletodefineCOPDandasthmaandoutlineadiff

4、erentialdiagnosisbeablelistimportanthistoricalandlaboratorydiagnosticfeaturesofCOPDbeabletodescribetheevidence-basedphysicalexaminationforCOPDandairflowlimitationCOPDI:DIAGNOSISCASE:A61yearoldmancomestoyourclinicasanewpatient.HehadjustbeenadmittedtohospitalforhisfirstexacerbationofCOP

5、D.Hehascompleteda10dayantibioticcourseand10daysoforalPrednisone.Heisnowonlyonanipratropiumpuffer,2puffsqid.HowisCOPDdefined?Whatisemphysema?Whatisasthma?WhyisitimportanttomakeadiagnosisofCOPD(asopposedtoasthma)inthispatient?COPDI:DIAGNOSISCOPDDefinition:Apreventableandtreatabledisease

6、statecharacterizedbyairflowlimitationthatisnotfullyreversible.Theairflowlimitationisusuallyprogressiveandassociatedwithanabnormalinflammatoryresponseofthelungstonoxiousparticlesorgases,primarilycausedbycigarettesmoking.AlthoughCOPDaffectsthelungs,italsoproducessignificantsystemicconse

7、quences.ImpliespostbronchodilatorFEV1/FVC<0.7ATS/ERSpositionpaperCOPDI:DIAGNOSISCOPD:traditionallyunderstoodasaspectrum-componentsofchronicbronchitisoremphysema.ThelattermaytakeonrevitalizedsignificancebecauseofanewapproachthatconsiderstheimportanceofdifferentphenotypesofCOPD.EMPHYSEM

8、A:Abn