Wedzicha Jadwiga A, Hurst John R
Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, University College London, Rowland Hill Street, Hampstead, London NW3 2PF, UK.
Proc Am Thorac Soc. 2007 Dec;4(8):602-5. doi: 10.1513/pats.200707-106TH.
Chronic obstructive pulmonary disease (COPD) exacerbations have a major impact on patients with COPD, yet they are complex events that are associated with a number of triggers and affected by the underlying disease process. A number of conditions can mimic the symptoms of an exacerbation and require evaluation. Airway and systemic inflammatory changes at exacerbation are modulated by infective factors (viruses and bacteria) and lead to the pathophysiologic effects seen at exacerbations with increase in airflow obstruction. Although bacteria or viruses can be isolated at exacerbation, often these organisms act in combination and lead to greater inflammatory changes and more severe exacerbation. Underlying structural changes such as radiologic changes of bronchiectasis that can be found in COPD can also modulate exacerbation severity and contribute to morbidity associated with exacerbations.
慢性阻塞性肺疾病（COPD）急性加重对COPD患者有重大影响，但它们是复杂的事件，与多种触发因素相关，并受潜在疾病进程的影响。许多情况可模仿急性加重的症状，需要进行评估。急性加重时气道和全身的炎症变化由感染因素（病毒和细菌）调节，并导致急性加重时出现气流阻塞增加等病理生理效应。虽然在急性加重时可分离出细菌或病毒，但这些病原体通常联合作用，导致更严重的炎症变化和更严重的急性加重。COPD中可见的潜在结构变化，如支气管扩张的影像学改变，也可调节急性加重的严重程度，并导致与急性加重相关的发病率增加。
