Hurst John R, Wedzicha Jadwiga A
Academic Unit of Respiratory Medicine, Royal Free Campus, UCL Medical School, London, UK.
BMC Med. 2009 Aug 7;7:40. doi: 10.1186/1741-7015-7-40.
Exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is now additional focus on addressing comorbidities and taking the opportunity at acute events to optimise preventative strategies for the future. Ultimately, exacerbations are heterogeneous events in a heterogeneous disease, and an individualised approach is paramount.
慢性阻塞性肺疾病（COPD）急性加重是这种常见且具有破坏性疾病自然史中的重要事件。本综述对急性加重的预防和管理进行了简洁的、最新的总结。大量新数据为许多现有的预防干预措施（包括药物和非药物措施）提供了证据支持。在开发新方法以及在正确的时间将现有方法应用于合适的患者方面，挑战依然存在。急性加重的管理仍根据临床严重程度逐步进行，但现在额外关注合并症的处理，并利用急性事件的机会优化未来的预防策略。最终，急性加重在这种异质性疾病中是异质性事件，个体化方法至关重要。
