COPD英文课件WorldCOPDDay.ppt

COPD英文课件WorldCOPDDay.ppt

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WorldCOPDDayChronicObstructivePulmonaryDiseasePressConferenceKyoto,JapanNovember19,2006,OpeningRemarksYoshinosukeFukuchi,MD,PhDIntroductionofGOLDSoniaBuist,MDNewGOLDGuidelinesSuzanneHurd,PhDKlausF.Rabe,MD,PhDAdditionalCommentsPeterCalverley,MDCommentsfromWONCAChrisvanWeel,MDClosingRemarksClaudeLenfant,MD,WorldCOPDDayPressConference,DefinitionofCOPD,ChronicObstructivePulmonaryDiseaseisapreventableandtreatablediseasewithsomesignificantextrapulmonaryeffects.Thepulmonarycomponentischaracterizedbyairflowlimitationthatisnotfullyreversible.,HealthyAlveolus,COPD,ChronicObstructivePulmonaryDisease（COPD）,TheairflowlimitationinCOPDisusuallyprogressiveandassociatedwithanabnormalinflammatoryresponseofthelungstonoxiousparticlesandgasesSevereCOPDleadstorespiratoryfailure,hospitalizationandeventuallydeathfromsuffocation,RiskFactorsforCOPD,Nutrition,Infections,Socio-economicstatus,AgingPopulations,Dr.A.SoniaBuistIntroductionofGOLD,Chair,GOLDExecutiveCommitteePortland,OregonUSA,lobalInitiativeforChronicbstructiveungisease,GOLD,November19,2006WorldCOPDDay,KyotoJapan,WhywasGOLDStarted?

ThesocialandeconomicburdenofCOPDisincreasingrapidlyincountriesatalllevelsofeconomicdevelopmentCOPDisunder-appreciated,under-diagnosedandunder-treatedImportantquestionsaboutCOPDarestillunanswered,COPDisUnder-appreciatedandUnder-diagnosed,ExamplefromJapan:

NICESurveyofCOPDprevalenceCarriedoutinseveralregionsofJapanusingstandardizedmethods,COPDPrevalenceRate（adjusted）*inPopulation40years,*Adjustedforage,sex,cluster*8.5-10.9%dependingoncriteria,Study,Fukuchietal.Respirology2004;9:

458-65,0.3%,8.5%*,5.3vs0.2MCOPDpatientsinJapan40years,MHWSurvey,COPDPrevalenceSurvey（NICE）inJapan,Hadpriordiagnosis,Didnothavepriordiagnosis:

Fukuchietal.Respirology2004;9:

458-65,PrevalenceofGOLDStage1+COPD1,Guangzhou,China,1FEV1/FVC0.70,postBD,MEN15.3%,WOMEN7.6%,OfthesixleadingcausesofdeathintheUnitedStates,onlyCOPDhasbeenincreasingsteadilysince1970.,Source:

JemalA.etal.JAMA2005,COPDMortalitybyGender,U.S.,1980-2000,NumberDeathsx1000,19902020IschaemicheartdiseaseCerebrovasculardiseaseLowerrespinfectionDiarrhoealdiseasePerinataldisordersCOPDTuberculosisMeaslesRoadTrafficAccidentsLungCancer,StomachCancerHIVSuicide,6th,3rd,COPDMortalityWorldwide,Source:

Murray&Lopez.Lancet1997,WhyisCOPDIncreasingWorldwide?

Increaseinexposuretoriskfactors（especiallytobacco）indevelopingcountries&inwomenChangingdemographicsgloballywithmoreofthepopulation,especiallyinthedevelopingcountrieslivingintotheCOPDagerange,Dr.SuzanneS.HurdNewGOLDGuidelines,GOLDScientificDirectorGaithersburg,Maryland,USA,GOLDObjectives,IncreaseawarenessofCOPDamonghealthprofessionals,healthauthorities,andthegeneralpublicImprovediagnosis,managementandpreventionofCOPDStimulateresearchinCOPD,GlobalStrategyforDiagnosis,ManagementandPreventionofCOPD,Definition,ClassificationBurdenofCOPDRiskfactorsPathogenesis,pathology,pathophysiologyManagementPracticalConsiderations,Revised2006,MAJORCHANGESGlobalStrategyforDiagnosis,ManagementandPreventionofCOPDRevised2006,Revised2006,Dr.KlausRabeNewGOLDGuidelines,Chair,GOLDScienceCommitteeLeiden,TheNetherlands,GlobalStrategyforDiagnosis,ManagementandPreventionofCOPD,Definition,ClassificationBurdenofCOPDRiskfactorsPathogenesis,pathology,pathophysiologyManagementPracticalConsiderations,Revised2006,DefinitionofCOPD,ChronicObstructivePulmonaryDisease（COPD）isapreventableandtreatablediseasewithsomesignificantextrapulmonaryeffectsthatmaycontributetotheseverityinindividualpatients.,Itspulmonarycomponentischaracterizedbyairflowlimitationthatisnotfullyreversible.,Theairflowlimitationisusuallyprogressiveandassociatedwithanabnormalinflammatoryresponseofthelungtonoxiousparticlesorgases.,SYMPTOMS,cough,sputum,shortnessofbreath,EXPOSURETORISKFACTORS,tobacco,occupation,indoor/outdoorpollution,SPIROMETRY,DiagnosisofCOPD,SpirometryforCOPDDiagnosisandClassificationofSeverity,ClassificationofCOPDSeveritybySpirometry,StageI:

MildFEV1/FVC80%predictedStageII:

ModerateFEV1/FVC0.7050%FEV180%predictedStageIII:

SevereFEV1/FVC0.7030%FEV150%predictedStageIV:

VerySevereFEV1/FVC0.70FEV130%predictedorFEV150%predictedpluschronicrespiratoryfailure,COPDandCo-Morbidities,COPDhassignificantextrapulmonary（systemic）effectsWeightloss,nutritionalabnormalitiesSkeletalmuscledysfunction,COPDandCo-Morbidities,COPDpatientsareatincreasedrisk:

Myocardialinfarction,anginaOsteoporosisRespiratoryinfectionDepressionDiabetesCOPDandlungcancer,Dr.PeterCalverleyNewGOLDGuidelines,GOLDExecutive/ScienceCommitteeLiverpool,England,GlobalStrategyforDiagnosis,ManagementandPreventionofCOPD,Definitio