COPD英文课件WorldCOPDDay.ppt

1、World COPD Day Chronic Obstructive Pulmonary DiseasePress Conference Kyoto,JapanNovember 19,2006,Opening RemarksYoshinosuke Fukuchi,MD,PhDIntroduction of GOLDSonia Buist,MDNew GOLD GuidelinesSuzanne Hurd,PhD Klaus F.Rabe,MD,PhDAdditional CommentsPeter Calverley,MDComments from WONCAChris van Weel,MD

2、Closing RemarksClaude Lenfant,MD,World COPD Day Press Conference,Definition of COPD,Chronic Obstructive Pulmonary Disease is a preventable and treatable disease with some significant extrapulmonary effects.The pulmonary component is characterized by airflow limitation that is not fully reversible.,H

3、ealthy Alveolus,COPD,Chronic Obstructive Pulmonary Disease(COPD),The airflow limitation in COPD is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles and gasesSevere COPD leads to respiratory failure,hospitalization and eventually death from s

4、uffocation,Risk Factors for COPD,Nutrition,Infections,Socio-economic status,Aging Populations,Dr.A.Sonia Buist Introduction of GOLD,Chair,GOLD Executive CommitteePortland,Oregon USA,lobal Initiative for Chronicbstructiveungisease,G OLD,November 19,2006World COPD Day,Kyoto Japan,Why was GOLD Started?

5、,The social and economic burden of COPD is increasing rapidly in countries at all levels of economic developmentCOPD is under-appreciated,under-diagnosed and under-treatedImportant questions about COPD are still unanswered,COPD is Under-appreciated and Under-diagnosed,Example from Japan:NICE Survey

6、of COPD prevalenceCarried out in several regions of Japan using standardized methods,COPD Prevalence Rate(adjusted)*in Population 40 years,*Adjusted for age,sex,cluster*8.5-10.9%depending on criteria,Study,Fukuchi et al.Respirology 2004;9:458-65,0.3%,8.5%*,5.3 vs 0.2M COPD patients in Japan 40 years

7、,MHW Survey,COPD Prevalence Survey(NICE)in Japan,Had prior diagnosis,Did not have prior diagnosis:,Fukuchi et al.Respirology 2004;9:458-65,Prevalence of GOLD Stage 1+COPD1,Guangzhou,China,1 FEV1/FVC0.70,post BD,MEN15.3%,WOMEN7.6%,Of the six leading causes of death in the United States,only COPD has

8、been increasing steadily since 1970.,Source:Jemal A.et al.JAMA 2005,COPD Mortality by Gender,U.S.,1980-2000,Number Deaths x 1000,1990 2020Ischaemic heart diseaseCerebrovascular diseaseLower resp infectionDiarrhoeal diseasePerinatal disordersCOPDTuberculosisMeaslesRoad Traffic AccidentsLung Cancer,St

9、omach CancerHIVSuicide,6th,3rd,COPD Mortality Worldwide,Source:Murray&Lopez.Lancet 1997,Why is COPD Increasing Worldwide?,Increase in exposure to risk factors(especially tobacco)in developing countries&in womenChanging demographics globally with more of the population,especially in the developing co

10、untries living into the COPD age range,Dr.Suzanne S.Hurd New GOLD Guidelines,GOLD Scientific DirectorGaithersburg,Maryland,USA,GOLD Objectives,Increase awareness of COPD among health professionals,health authorities,and the general publicImprove diagnosis,management and prevention of COPDStimulate r

11、esearch in COPD,Global Strategy for Diagnosis,Management and Prevention of COPD,Definition,ClassificationBurden of COPDRisk factorsPathogenesis,pathology,pathophysiologyManagementPractical Considerations,Revised 2006,MAJOR CHANGESGlobal Strategy for Diagnosis,Management and Prevention of COPDRevised

12、 2006,Revised 2006,Dr.Klaus Rabe New GOLD Guidelines,Chair,GOLD Science CommitteeLeiden,The Netherlands,Global Strategy for Diagnosis,Management and Prevention of COPD,Definition,ClassificationBurden of COPDRisk factorsPathogenesis,pathology,pathophysiologyManagementPractical Considerations,Revised

13、2006,Definition of COPD,Chronic Obstructive Pulmonary Disease(COPD)is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients.,Its pulmonary component is characterized by airflow limitation that is not fully reversib

14、le.,The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.,SYMPTOMS,cough,sputum,shortness of breath,EXPOSURE TO RISKFACTORS,tobacco,occupation,indoor/outdoor pollution,SPIROMETRY,Diagnosis of COPD,Spirometry for

15、 COPD Diagnosis and Classification of Severity,Classification of COPD Severity by Spirometry,Stage I:Mild FEV1/FVC 80%predictedStage II:Moderate FEV1/FVC 0.70 50%FEV1 80%predictedStage III:Severe FEV1/FVC 0.70 30%FEV1 50%predictedStage IV:Very Severe FEV1/FVC 0.70 FEV1 30%predicted or FEV1 50%predic

16、ted plus chronic respiratory failure,COPD and Co-Morbidities,COPD has significant extrapulmonary(systemic)effectsWeight loss,nutritional abnormalitiesSkeletal muscle dysfunction,COPD and Co-Morbidities,COPD patients are at increased risk:Myocardial infarction,anginaOsteoporosisRespiratory infectionDepressionDiabetesCOPD and lung cancer,Dr.Peter Calverley New GOLD Guidelines,GOLD Executive/Science CommitteeLiverpool,England,Global Strategy for Diagnosis,Management and Prevention of COPD,Definitio