咳嗽和痰液生成是COPD患者预后较差的一个危险因素
2011/05/12
摘要
慢性阻塞性肺疾病(COPD)在发达国家具有很高的发病率和致死率。在未来几十年内，COPD患病率还将持续增加。据世界卫生组织报道，到2020年，COPD将成为导致死亡的第三位原因。COPD的病程呈现慢性、进行性变化，在恶化因素（主要是支气管感染）存在时常常导致病情恶化。COPD恶化主要表现为急性症状（特别是咳嗽、呼吸困难和痰液产生）增加并持续一段时间，这些症状会导致气流受阻更为严重，严重影响患者的生活质量，通常来说还需要对常规治疗进行调整。COPD恶化是导致COPD患者入院就诊、住院和死亡的主要原因，经常恶化也会导致患者的健康状况恶化，引起肺功能的持续性下降。慢性咳嗽和痰液产生在普通COPD人群很常见，但在存在呼吸道疾病的患者中更为常见。这些症状被认为是COPD恶化的危险因素。本文对慢性咳嗽和痰液产生对COPD患者造成的影响进行综述，并分析这些危险因素是否能用于鉴别那些有特异性表型的患者，以采取不同治疗措施以减少COPD的恶化。
（陈欣 审校）
Respir Med. 2011 Feb 24. [Epub ahead of print]
Cough and sputum production as risk factors for poor outcomes in patients with COPD.
Miravitlles M.
Fundació Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ciber de Enfermedades Respiratorias (CIBERES), Hospital Clinic, Barcelona, Spain.
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in developed countries, and its prevalence is projected to increase over the coming decades. According to the World Health Organization, COPD will become the third leading cause of death worldwide by 2020. COPD has a chronic and progressive course, and is often aggravated by exacerbations, which typically arise as a result of bronchial infection. Exacerbations are characterised by periods of increasing acute symptoms, particularly cough, dyspnoea and production of sputum, which worsen airflow obstruction, further impair quality of life and generally require a change in regular medication. Exacerbations are the most common cause of medical visits, hospital admissions and death in patients with COPD, and frequent exacerbations worsen health status and may cause a permanent decline in lung function. Chronic cough and sputum production are common in the general population, but significantly more prevalent in patients with respiratory disorders; these symptoms have been suggested as a risk factor for exacerbations of COPD. This article will review the consequences of chronic cough and sputum production in patients with COPD and analyse whether these risk factors may be useful for identifying a specific phenotype of patient that requires different management to reduce the occurrence of exacerbations.
Respir Med. 2011 Feb 24. [Epub ahead of print]
慢性阻塞性肺疾病(COPD)在发达国家具有很高的发病率和致死率。在未来几十年内，COPD患病率还将持续增加。据世界卫生组织报道，到2020年，COPD将成为导致死亡的第三位原因。COPD的病程呈现慢性、进行性变化，在恶化因素（主要是支气管感染）存在时常常导致病情恶化。COPD恶化主要表现为急性症状（特别是咳嗽、呼吸困难和痰液产生）增加并持续一段时间，这些症状会导致气流受阻更为严重，严重影响患者的生活质量，通常来说还需要对常规治疗进行调整。COPD恶化是导致COPD患者入院就诊、住院和死亡的主要原因，经常恶化也会导致患者的健康状况恶化，引起肺功能的持续性下降。慢性咳嗽和痰液产生在普通COPD人群很常见，但在存在呼吸道疾病的患者中更为常见。这些症状被认为是COPD恶化的危险因素。本文对慢性咳嗽和痰液产生对COPD患者造成的影响进行综述，并分析这些危险因素是否能用于鉴别那些有特异性表型的患者，以采取不同治疗措施以减少COPD的恶化。
（陈欣 审校）
Respir Med. 2011 Feb 24. [Epub ahead of print]
Cough and sputum production as risk factors for poor outcomes in patients with COPD.
Miravitlles M.
Fundació Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ciber de Enfermedades Respiratorias (CIBERES), Hospital Clinic, Barcelona, Spain.
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in developed countries, and its prevalence is projected to increase over the coming decades. According to the World Health Organization, COPD will become the third leading cause of death worldwide by 2020. COPD has a chronic and progressive course, and is often aggravated by exacerbations, which typically arise as a result of bronchial infection. Exacerbations are characterised by periods of increasing acute symptoms, particularly cough, dyspnoea and production of sputum, which worsen airflow obstruction, further impair quality of life and generally require a change in regular medication. Exacerbations are the most common cause of medical visits, hospital admissions and death in patients with COPD, and frequent exacerbations worsen health status and may cause a permanent decline in lung function. Chronic cough and sputum production are common in the general population, but significantly more prevalent in patients with respiratory disorders; these symptoms have been suggested as a risk factor for exacerbations of COPD. This article will review the consequences of chronic cough and sputum production in patients with COPD and analyse whether these risk factors may be useful for identifying a specific phenotype of patient that requires different management to reduce the occurrence of exacerbations.
Respir Med. 2011 Feb 24. [Epub ahead of print]
