天气渐冷，空气中的烟尘、汽车尾气增多，冷空气直接进入呼吸道——— The weather becomes cold,Smoke in the air/Car exhaust increase,Cold air directly into the respiratory tract -- -

提防慢阻肺急性加重 Beware of copd exacerbations

受访专家/广东省人民医院呼吸内科主任 陈正贤 Interviewed experts/guangdong province people's hospital respiratory head of the medical department ChenZhengXian

　　广州天气渐冷，又到了慢性阻塞性肺疾病(慢阻肺)临床症状明显以及急性加重的高发季节。昨日是第11个世界慢性阻塞性肺疾病日，今年主题“关注慢阻肺，永远不晚”。呼吸内科医生在接受羊城晚报记者采访时表示，秋冬季是慢阻肺发作和加重的季节。慢阻肺患者要格外注意自我防护，适量减少外出活动，避免吸入过多污染物，减少呼吸道感染机会；在治疗上，要坚持长期规范用药，从而打好冬季“阻击”慢阻肺急性加重的关键战役。

Guangzhou colder,And the chronic obstructive pulmonary disease(copd)Clinical symptoms and acute aggravating high-risk season.Yesterday is the 11th world, chronic obstructive pulmonary disease,This year, the message"Focus on copd,Never late".Breathing physicians in accepting the yangcheng evening news reporter to interview said,Qiu dong season is copd attack and aggravation of the season.Copd patients should be more attention to self protection,Right amount reduced outdoor activities,Avoid suction too many pollutants,Reduce respiratory tract infection;In the treatment,To adhere to the long-term drug standard,So as to play a good winter"block"Copd exacerbations key campaign.

急性加重期肺功能会下降 Exacerbations period lung function will decline

　　慢阻肺，是一种逐渐削弱患者呼吸功能的破坏性慢性肺部疾病，被称为是呼吸道疾病中最“不动声色”的隐形杀手。

copd,Is a kind of gradually weaken the patient respiratory function destructive chronic lung diseases,Known as chronic respiratory disease is the most"Stay calm and collected"Invisible killer.

　　广东省人民医院呼吸内科主任陈正贤介绍，从病情发展来看，慢阻肺分为“稳定期”和“急性加重期”。由于人体肺脏具有较强的代偿能力，疾病进展隐秘，患者在日常“稳定期”时疾病特征不明显，却在“急性加重期”时症状骤然出现或原有症状急剧恶化。更为可怕的是，每一次慢阻肺急性加重发作后，患者的肺功能大多会进一步下降，即病情的不可逆性恶化，从而加快疾病进程，增加死亡的风险。

Guangdong province people's hospital respiratory head of the medical department ChenZhengXian is introduced,From illness development to see,Copd is divided into"Stationary phase"and"Exacerbations period".Due to human lung has strong compensatory ability,Secret disease progression,Patients in daily"Stationary phase"With disease characteristics is not obvious,But in"Exacerbations period"When the symptom suddenly appear or original symptoms worsen sharply.More terrible is,Each time the copd exacerbations after the attack,Most patients with lung function will further decline,That is the irreversible illness worse,So as to speed up the disease process,Increasing the risk of death.

　　“急性加重是慢阻肺患者住院的主要原因，急性加重期间产生的相关费用又占到了慢阻肺患者整体费用的40%-70%。有研究显示，因慢阻肺急性加重而住院的患者中有8%左右在住院期间死亡，而有近一半的患者在自住院起的三年内死亡。”陈正贤说，“而且，在慢阻肺急性加重发生之后，患者仍然伴有发生后续急性加重的风险，尤其是在初次发生急性加重之后的两个月内。”

"Exacerbations in patients with copd is a leading cause of hospitalization in,Exacerbations produced during related expenses and accounted for copd patients to the overall cost of 40% - 70%.Research shows that,For copd exacerbations and hospitalized patients with 8% in hospital in death,But nearly half of the patients in hospital three years since the death."ChenZhengXian said,"and,In the copd exacerbations happen later,The patient has accompanied by subsequent risk of exacerbations,Especially in occurred first exacerbations after two months."

据世界卫生组织最新统计，目前全球已有2.1亿慢阻肺患者。在中国，40岁以上人群总患病率高达8.2%，共有4300万人患有慢阻肺，预防慢阻肺及其急性加重工作刻不容缓。 According to the world health organization latest statistics,The world has 210 million copd patients.In China,More than 40 people total prevalence rate is as high as 8.2%,A total of 43 million people with copd,Prevention of copd exacerbations and it is work.

秋冬季尤需预防急性加重 Qiu dong season especially need to prevent exacerbations

　　陈正贤指出，许多患者每年可发生两次或多次的慢阻肺急性加重，秋冬季尤其高发。秋冬季空气中的烟尘、汽车尾气增多，加上寒冷的空气直接进入呼吸道，可能诱发慢阻肺的急性发作，进入急性加重期。另外，即使是健康人，如果空气中的污染物长期刺激呼吸道，也可能会诱发气管或肺部组织发生病变，导致慢阻肺的发生。

ChenZhengXian pointed out that,Many patients can happen every year two or multiple copd exacerbations,Qiu dong season especially high.Qiu dong season in the air the smoke and dust/Car exhaust increase,And cold air directly into the respiratory tract,Can induce acute attack of copd,Enter exacerbations period.In addition,Even if is healthy,If the air pollutant long-term stimulus respiratory tract,May also be induced tracheal or lung tissue disease,Lead to the occurrence of copd.

　　其中，对于长期吸烟、年龄超过40岁、有职业粉尘和化学物质接触史、日常工作或生活环境存在空气污染或有慢阻肺家族史的高危人群，秋冬季也是提防慢阻肺发生及急性加重的关键期。

the,For long-term smoking/Over the age of 40,/Have professional dust and chemical exposure/Daily work or living environment in air pollution or a family history of copd high-risk groups,Qiu dong season is also beware of copd exacerbations happening and the critical period.

　　他介绍，当慢阻肺患者出现了呼吸困难、活动能力下降等疾病晚期症状时，往往便是患者即将进入相对频繁发生急性加重阶段的预警信号。很多大型研究都表明，慢阻肺患者的肺功能越差，病情越重，发生急性加重的可能性也明显增加。“因此，在病情恶化、出现频繁急性加重前及时展开治疗，是降低疾病危险的关键”。

He introduced,When copd patients appeared difficulty breathing/Activities such as reduced ability adanced disease symptoms,Often be patients is about to enter the relative frequent exacerbations stage of the early warning signal.Many studies have shown that large,Copd patients with pulmonary function the difference,Condition is heavier,The possibility of an acute aggravated also increased significantly."therefore,In his condition deteriorated/Frequent exacerbations appear before to carry out treatment in time,The key is to reduce the disease risk".

患者出行宜在上午十点后 Patients should travel after 10 o 'clock in the morning

　　陈正贤建议，对处于稳定期的慢阻肺患者，需要坚持长期使用包括长效抗胆碱能药物如噻托溴铵等在内的基础维持治疗药物来预防急性加重，“但很多慢阻肺的病人不能持续用药，所以天气转冷特别容易诱发感染，以致急性发作。”对于出现严重呼吸困难的慢阻肺病人，当药物已不能很好地控制咳嗽、气喘时，可考虑采用微创治疗———支气管内活瓣肺减容术，“该手术有非常严格适应证，只有肺部病灶为非均质性改变且无旁路通气存在的重度慢阻肺病人适合接受此项治疗。”陈正贤说，“目前临床大约有20%左右的人有可能手术成功。”

ChenZhengXian Suggestions,The stationary phase in copd patients,To adhere to the long-term use of including long-term anticholinergic drugs such as beauty and Joe bromide, basic maintenance therapy drugs to prevent exacerbations,"But a lot of copd patients can't continued drug use,So cold weather especially easy to cause infection,So that acute attack."For severe difficulty breathing slowly resistance pulmonary disease person,When drugs already can not very well control cough/Asthma when,Can consider to use minimally invasive treatment -- endobronchial flapper lung capacity reduction technique,"The operation has a very strict indication,Only lung lesions for heterogeneity change without bypass air exist severe slow resistance pulmonary disease one fit for accepting the treatment."ChenZhengXian said,"The clinical about 20% of people might be successful operation."

　　他最后提醒，由于慢阻肺多发于中老年人群，应注意减少骨质疏松的风险，避免在慢阻肺急性加重时反复使用糖皮质激素。此外，慢阻肺急性加重患者出院后，可在门诊治疗期间早期肺功能康复，改善运动能力和健康状态。日常生活中，戒烟是最基本的预防策略，同时应提前注射流感疫苗以及肺炎链球菌疫苗。

He finally remind,Because of copd happens in middle-aged and elderly people,Should pay attention to reduce the risk of osteoporosis,Avoid in copd exacerbations use repeatedly when glucocorticoid.In addition,Copd exacerbations patients after discharge,In the clinic treatment of lung function during early rehabilitation,Improve athletic ability and state of health.In daily life,To give up smoking is the most basic prevention strategy,At the same time to get a flu vaccination in advance and streptococcus pneumoniae vaccine.

　　对于慢阻肺患者来说，在注意防寒保暖的基础上，也需要进行适当的锻炼，慢阻肺患者要适量减少在冬季的外出活动，出行尽量安排在上午10点以后，避开清晨的高污染空气。即使宅在家，在允许的范围内还是要动起来，患者可以视自身情况而定，做一些舒缓的运动，如打太极拳等。(文/记者 余燕红)

For for patients with copd,On the basis of warm warm attention,Also the need for proper exercise,Copd patients to reduce the amount in the winter out activities,Travel arranged as far as possible in after 10 o 'clock in the morning,Early in the morning to avoid high polluted air.Even if the house at home,In the permitted range or to move,Patients can apparent oneself circumstance and decide,Do some slow motion,Such as tai chi, etc.(Wen/reporter YuYanGong)