Martin T R, Lewis S W, Albert R K
Chest. 1982 Sep;82(3):310-4. doi: 10.1378/chest.82.3.310.
We followed the course of 36 consecutive patients hospitalized with chronic obstructive pulmonary disease and acute respiratory failure due to exacerbation of chronic bronchitis in order to clarify the prognosis in this common group of patients. All of the patients had spirometric evidence of severe, poorly reversible airflow limitation and all had a similar cause of acute respiratory failure. In addition, all received similar treatment during hospitalization and follow-up. Patients wtih asthma and pneumonia were excluded by clinical, spirometric, and roentgenographic criteria. Hospital survival was 94 percent, and only one patient required intubation. Two-year survival was 72 percent, and none of the patients died during a readmission for acute respiratory failure. This prognosis is much better than commonly recognized and compares favorably to that of stable outpatients with similar degrees of airflow limitation. An episode of acute respiratory failure, triggered by an exacerbation of chronic bronchitis, does not necessarily alter the prognosis of patients with COPD.
我们追踪了36例因慢性支气管炎急性加重而住院治疗慢性阻塞性肺疾病并伴有急性呼吸衰竭的连续病例，以明确这一常见患者群体的预后情况。所有患者均有肺功能检查证据表明存在严重且可逆性差的气流受限，并且所有患者急性呼吸衰竭的病因相似。此外，所有患者在住院期间及随访过程中均接受了相似的治疗。通过临床、肺功能及影像学标准排除了哮喘和肺炎患者。住院生存率为94%，仅1例患者需要插管治疗。两年生存率为72%，且没有患者在因急性呼吸衰竭再次入院期间死亡。这一预后情况比通常认为的要好得多，与具有相似气流受限程度的稳定门诊患者相比也更有利。由慢性支气管炎急性加重引发的急性呼吸衰竭发作不一定会改变慢性阻塞性肺疾病患者的预后。
