根据慢性阻塞性肺疾病全球创议(GOLD)的定义，慢性阻塞性肺疾病急性加重(AECOPD)是“在COPD的自然病程中发生的事件，气紧、咳嗽或／和咳痰等基础症状加重超出正常的日间变异的范围，急性发病，可能需要改变常规的治疗”[1]。AECOPD意味着对医疗卫生资源耗用的增加，如非预约的就医、使用药物增加，使用抗生素或口服皮质激素甚至住院，等等。仅仅依据是否占用卫生资源来定义AECOPD并不适当，这一点还要取决于医疗卫生资源的可获得性，同时有研究提示部分AECOPD可以是自限性的，特别是轻度急性加重。另一方面，占用医疗卫生资源的形式可以大致评估AECOPD的严重程度，如需要增加常规的吸人性药物常常意味着轻度AECOPD，需要短程口服抗生素或糖皮质激素意味着中度AECOPD，而需要住院者多为重度AECOPD。AECOPD是导致COPD患者健康状态降低乃至死亡的主要原因，也是耗用医疗卫生资源从而构成COPD疾病负担的主要部分，需要采用有力的干预措施以降低其发生率[2]。
Citation：
LIU Chuntao,FENG Yulin. Acute exacerbation of chronic obstructive pulmonary disease:Update. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(6): 413-415. doi:
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| 1. |
Rabe KF，Hurd S，Anzueto A，et al.Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：GOLD executive summary.Am J Respir Crit Care Med，2007，176：532-555.
|
| 2. |
Seemungal TA，Donaldson GC，Bhowmik A，et al.Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2000，161：1608-1613.
|
| 3. |
O’Donnell DE，Parker CM.COPD exacerbations 3：Pathophysiology.Thorax，2006，61：354-361.
|
| 4. |
Perera WR，Hurst JR，Wilkinson TM，et al.Inflammatory changes，recovery and recurrence at COPD exacerbation.Eur Respir J，2007，29：527-534.
|
| 5. |
Seemungal T，Harper-Owen R，Bhowmik A，et al.Respiratory viruses，symptoms，and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2001，164：1618-1623.
|
| 6. |
Hurst JR，Wilkinson TM，Perera WR，et al.Relationships among bacteria，upper airway，lower airway，and systemic inflammation in COPD.Chest，2005，127：1219-1226.
|
| 7. |
Ram FSF，Rodriguez-Roisin R，Granado-Navarrete A，et al.Antibiotics for exacerbation of chronic obstructive pulmonary disease.Cochrane Database Syst Rev，2006，2：CD004403.
|
| 8. |
Calverley PM，Anderson JA，Celli B，et al.Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.N Engl J Med，2007，356：775-789.
|
| 9. |
Calverley PM，Boonsawat W，Cseke Z，et al.Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease.Eur Respir J，2003，22：912-919.
|
| 10. |
Casanova C，Celli BR，Tost L，et al.Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD.Chest，2000，118：1582-1590.
|
- 1. Rabe KF，Hurd S，Anzueto A，et al.Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：GOLD executive summary.Am J Respir Crit Care Med，2007，176：532-555.
- 2. Seemungal TA，Donaldson GC，Bhowmik A，et al.Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2000，161：1608-1613.
- 3. O’Donnell DE，Parker CM.COPD exacerbations 3：Pathophysiology.Thorax，2006，61：354-361.
- 4. Perera WR，Hurst JR，Wilkinson TM，et al.Inflammatory changes，recovery and recurrence at COPD exacerbation.Eur Respir J，2007，29：527-534.
- 5. Seemungal T，Harper-Owen R，Bhowmik A，et al.Respiratory viruses，symptoms，and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2001，164：1618-1623.
- 6. Hurst JR，Wilkinson TM，Perera WR，et al.Relationships among bacteria，upper airway，lower airway，and systemic inflammation in COPD.Chest，2005，127：1219-1226.
- 7. Ram FSF，Rodriguez-Roisin R，Granado-Navarrete A，et al.Antibiotics for exacerbation of chronic obstructive pulmonary disease.Cochrane Database Syst Rev，2006，2：CD004403.
- 8. Calverley PM，Anderson JA，Celli B，et al.Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.N Engl J Med，2007，356：775-789.
- 9. Calverley PM，Boonsawat W，Cseke Z，et al.Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease.Eur Respir J，2003，22：912-919.
- 10. Casanova C，Celli BR，Tost L，et al.Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD.Chest，2000，118：1582-1590.
