Chronic obstructive pulmonary disease

被引:927
作者
Decramer, Marc [1 ]
Janssens, Wim [1 ]
Miravitlles, Marc [2 ]
机构
[1] Univ Louvain, Univ Hosp, Div Resp, B-3000 Louvain, Belgium
[2] Hosp Clin Barcelona, Fundacio Clin, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
关键词
INHALED ANTICHOLINERGIC BRONCHODILATOR; ACUTE EXACERBATIONS; LUNG-FUNCTION; VITAMIN-D; GLOBAL BURDEN; AIR-FLOW; SALMETEROL/FLUTICASONE PROPIONATE; FUNCTIONAL IMPAIRMENT; CARDIOVASCULAR EVENTS; RHINOVIRUS INFECTION;
D O I
10.1016/S0140-6736(11)60968-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects or comorbities. The main cause is smoking tobacco, but other factors have been identified. Several pathobiological processes interact on a complex background of genetic determinants, lung growth, and environmental stimuli. The disease is further aggravated by exacerbations, particularly in patients with severe disease, up to 78% of which are due to bacterial infections, viral infections, or both. Comorbidities include ischaemic heart disease, diabetes, and lung cancer. Bronchodilators constitute the mainstay of treatment: beta(2) agonists and long-acting anticholinergic agents are frequently used (the former often with inhaled corticosteroids). Besides improving symptoms, these treatments are also thought to lead to some degree of disease modification. Future research should be directed towards the development of agents that notably affect the course of disease.
引用
收藏
页码:1341 / 1351
页数:11
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