20xx年醫(yī)學(xué)專題—copd慢性阻塞性肺病(編輯修改稿)
2024-11-04 12:59 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 ,70,80,20,40,60,80,40,20,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Upper limit of normal,Worse,Better,44,第四十四頁(yè)，共八十四頁(yè)。,健康狀態(tài)與活動(dòng)(hu243。 d242。ng)能力,r = 0.51,Wedzicha et al. ERJ 1998,500,90,20,SGRQ score,Shuttle distance (m),100,0,200,250,300,350,50,60,70,80,150,50,400,450,30,40,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Worse,Better,45,第四十五頁(yè)，共八十四頁(yè)。,一年中健康(ji224。nkāng)狀態(tài)的改變與急性發(fā)作的頻率,0,1,2,2,2,2,6,8,6,0,4,4,SGRQ score change over 1 year,Number of exacerbations/year,,Jones et al. AJRCCM 2001,Worse,Better,46,第四十六頁(yè)，共八十四頁(yè)。,30,SGRQ score,Baseline (at presentation with acute exacerbation),26 weeks,35,40,45,50,55,,12 weeks,4 weeks,Spencer, Jones. AJRCCM 2001,COPD急性加重(jiāzh242。ng)后恢復(fù),47,第四十七頁(yè)，共八十四頁(yè)。,COPD的健康(ji224。nkāng)狀態(tài)與死亡率,DomingoSalvany et al. ERJ 2001,存活(cn hu243。) 死亡 Age 63 70 BMI 27 25 FEV1 49 36 SGRQ 40 50,303 例患者(hu224。nzhě)，追蹤隨訪6年,48,第四十八頁(yè)，共八十四頁(yè)。,步行距離(j249。l237。)與健康狀態(tài),100,0,80,60,20,40,0,200,400,600,800,1000,Incremental shuttle walk distance (m),SGRQ total,n = 25 r = 0.55 p = 0.002,,,,,,,Dowson et al. AJRCCM 2001,49,第四十九頁(yè)，共八十四頁(yè)。,高分辨CT密度(m236。d249。)分析 (DMA),Stockley. Data on file 2002,50,第五十頁(yè)，共八十四頁(yè)。,HRCT 與步行(b249。x237。ng)距離,80,0,40,20,0,200,400,600,800,Distance (m),DMA,60,1000,,,,,,,Dowson et al. AJRCCM 2001,n = 25 r = 0.63 p 0.001,51,第五十一頁(yè)，共八十四頁(yè)。,0.8,0.7,0.6,0.5,0.4,0.3,0.2,0.1,0.1,0.2,More,,,2,14,16,0,2年中FEV1的改變(gǎibi224。n),Patients,4,6,8,10,12,Change in FEV1 (L),0,Dowson et al. AJRCCM 2001,52,第五十二頁(yè)，共八十四頁(yè)。,長(zhǎng)效B2受體激動(dòng)劑 (LABAs) 對(duì)COPD的作用(zu242。y242。ng),53,第五十三頁(yè)，共八十四頁(yè)。,Salmeterol 減輕 COPD 急性發(fā)作(fāzu242。)的頻率,1.0,0,0.8,0.6,0.2,0,2,4,6,8,10,12,Weeks of treatment,Mahler et al. Chest 1999,Probability,Placebo,SALM,0.4,,,,,,,54,第五十四頁(yè)，共八十四頁(yè)。,Salmeterol 治療1年急性加重(jiāzh242。ng)的下降率,* p 0.001,1.5,0,1.0,Placebo (n = 678),Median exacerbation rate year,Salmeterol 50 181。g bd (n = 682),0.5,19% *,GSK Data on file,55,第五十五頁(yè)，共八十四頁(yè)。,氣促指數(shù)(zhǐsh249。) (Borg scale),Salmeterol 減輕(jiǎnqīng)活動(dòng)后氣促,* p 0.0005,O39。Donnell et al. AJRCCM 2002,SALM,Placebo,6,0,5,3,1,2,0,1,2,4,5,6,8,運(yùn)動(dòng)(y249。nd242。ng)時(shí)間 (min),4,,,*,7,3,56,第五十六頁(yè)，共八十四頁(yè)。,吸入激素(jī s249。)在 COPD中的作用,57,
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