Department of Family and Community Health, University of Minnesota, Minneapolis, MN, USA.
COPD Foundation, Miami, FL, USA.
Int J Chron Obstruct Pulmon Dis. 2021 Feb 12;16:289-299. doi: 10.2147/COPD.S222664. eCollection 2021.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Early detection and appropriate treatment and management of COPD can lower morbidity and perhaps mortality. Clinicians in the primary care setting provide the majority of COPD care and are pivotal in the diagnosis and management of COPD. In this review, we provide an overview of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, with a focus on the management of COPD in the primary care setting. We discuss the pathophysiology of COPD; describe COPD risk factors, signs, and symptoms that may facilitate earlier diagnosis of COPD; and reinforce the importance of spirometry use in establishing the diagnosis of COPD. Disease monitoring, as well as a review of the 2020 GOLD treatment recommendations, is also discussed. Patients and families are important partners in COPD management; therefore, we outline simple steps that may assist them in caring for those affected by COPD. Finally, we discuss nonpharmacological treatment options for COPD, COPD monitoring tools that may aid in the evaluation of disease progression and response to therapy, and the importance of developing a COPD action plan on an individualized basis.
慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因。早期发现和适当的治疗及管理 COPD 可以降低发病率，也许还可以降低死亡率。初级保健环境中的临床医生提供了大部分 COPD 护理，在 COPD 的诊断和管理中起着关键作用。在这篇综述中，我们提供了全球倡议慢性阻塞性肺疾病（GOLD）2020 年报告的概述，重点是初级保健环境中 COPD 的管理。我们讨论了 COPD 的病理生理学；描述了可能有助于更早诊断 COPD 的 COPD 危险因素、体征和症状；并强调了在确定 COPD 诊断中使用肺活量计的重要性。还讨论了疾病监测以及对 2020 年 GOLD 治疗建议的审查。患者及其家属是 COPD 管理的重要伙伴；因此，我们概述了一些简单的步骤，以帮助他们照顾受 COPD 影响的人。最后，我们讨论了 COPD 的非药物治疗选择、可能有助于评估疾病进展和对治疗反应的 COPD 监测工具，以及制定个体化 COPD 行动计划的重要性。
