路漫漫--慢性阻塞性肺疾病急性加重高风险的识别与管理能力提升

Long way to go:to improve recognition and management of acute exacerbation of chronic obstructive pulmonary disease

慢性阻塞性肺疾病是位列第3的死亡病因,慢性阻塞性肺疾病急性加重(AECOPD)是驱动疾病进展、影响健康状况和增加医疗负担的重要因素之一,是临床防治的重点。然而,临床研究的结果显示,AECOPD未报告或漏识别率超过50%,影响评估和针对性管理能力。提高AECOPD识别与管理能力需要加强重视,研发识别AECOPD的简单易行的工具,建立对AECOPD识别和管理的专家共识和临床路径,才能把AECOPD识别与管理能力提升落到实处。近年研发的慢性阻塞性肺疾病急性加重识别工具是有代表性的"患者容易理解"和"简单易行"的识别工具,方便临床普及。慢性阻塞性肺疾病急性加重工具和慢性阻塞性肺疾病急性加重和症状评分等则属于利用智能手机应用软件的"客观量化"的工具,特别适合临床研究。这些工具和专家共识与临床路径的推出,将会助力AECOPD识别与管理能力提升,最大限度降低AECOPD对疾病负担和进展的影响。

Chronic obstructive pulmonary disease ranks the third of death cause worldwide.Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is an important factor in driving the progress of the disease,in impairing health status,and in increasing health-related economic burden.Therefore,prevention and management of AECOPD are considered the most important issue in clinical practice.According to the research reports,over 50%AECOPD was unreported or ignored,which rendered the inadequate recognition and management of AECOPD.In order to enhance the ability of AECOPD recognition and management,greater attention,development of easy to implement tool,expert consensus,and clinical pathway are of great importance.There are significant advances recently in developing tools for recognition and evaluation of AECOPD.COPD Exacerbation Recognition Tool is characterized by easy understanding by patients,simple to use,and particularly appropriate for use in daily practice.Exacerbations of Chronic Obstructive Pulmonary Disease Tool and Exacerbations and Symptoms in COPD are another type of tools characterized by smart phone-based and APP-supported digital objective evaluation,which is proper for use in clinical research.All these tools as well as the expert consensus and clinical pathway will contribute to the improvement of recognition and management of AECOPD,which will result in better outcomes and less disease burden in AECOPD high risk population.