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老年人慢性阻塞性肺疾病。

Chronic Obstructive Pulmonary Disease in the elderly.

机构信息

Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University and Teaching Hospital, Rome, Italy; San Raffaele - Cittadella della Carità Foundation, Taranto, Italy.

Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University and Teaching Hospital, Rome, Italy.

出版信息

Eur J Intern Med. 2014 Apr;25(4):320-8. doi: 10.1016/j.ejim.2013.10.001. Epub 2013 Oct 30.

Abstract

The prevalence of Chronic Obstructive Pulmonary Disease (COPD) dramatically increases with age, and COPD complicated by chronic respiratory failure may be considered a geriatric condition. Unfortunately, most cases remain undiagnosed because of atypical clinical presentation and difficulty with current respiratory function diagnostic standards. Accordingly, the disease is under-recognized and undertreated. This is expected to impact noticeably the health status of unrecognized COPD patients because a timely therapy could mitigate the distinctive and important effects of COPD on the health status. Comorbidity also plays a pivotal role in conditioning both the health status and the therapy of COPD besides having major prognostic implication. Several problems affect the overall quality of the therapy for the elderly with COPD, and current guidelines as well as results from pharmacological trials only to some extent apply to this patient. Finally, physicians of different specialties care for the elderly COPD patient: physician's specialty largely determines the kind of approach. In conclusion, COPD, in itself a complex disease, becomes difficult to identify and to manage in the elderly. Interdisciplinary efforts are desirable to provide the practicing physician with a multidisciplinary guide to the identification and treatment of COPD.

摘要

慢性阻塞性肺疾病(COPD)的患病率随着年龄的增长而显著增加,合并慢性呼吸衰竭的 COPD 可被视为老年病。不幸的是,由于不典型的临床表现和当前呼吸功能诊断标准的困难,大多数病例仍未被诊断。因此,该疾病的认识和治疗不足。这预计会明显影响未被识别的 COPD 患者的健康状况,因为及时的治疗可以减轻 COPD 对健康状况的独特和重要影响。合并症除了具有重要的预后意义外,对 COPD 的健康状况和治疗也起着关键作用。几个问题影响着 COPD 老年患者整体治疗质量,当前指南以及药物试验结果在某种程度上仅适用于此类患者。最后,不同专业的医生为老年 COPD 患者提供治疗:医生的专业在很大程度上决定了治疗方法。总之,COPD 本身就是一种复杂的疾病,在老年人中更难以识别和管理。需要跨学科的努力,为执业医生提供 COPD 的多学科识别和治疗指南。

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