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作者提出慢性阻塞性肺疾病(COPD)患者临床表现差别较大,症状与肺功能不完全平行,《慢性阻塞性肺疾病诊治指南(2007年修订版)》(简称《指南2007年版》)中提出的治疗方案主要依据肺功能制定,照顾临床症状较少,建议对COPD 患者结合临床资料进行分型,采用不同的治疗,“对严重咳嗽为主者,应不同于单纯痰多或气短者”的想法是积极的,有一定的合理性。但存在以下问题:(1)根据症状分型有较多困难和不确定性,不同患者对症状的敏感性不同,同一患者不同阶段症状表现不同,按病理改变区分为气道病变为主型或肺气肿型需要高分辨率 CT 和肺功能作为依据,这
The authors suggest that patients with chronic obstructive pulmonary disease (COPD) have significantly different clinical manifestations and symptoms that are not completely parallel with pulmonary function. The “Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Diseases (2007 Revision)” (“Guide 2007”) Of the treatment program is mainly based on the development of pulmonary function to take care of clinical symptoms less recommended COPD patients with clinical data classification, the use of different treatments, "mainly for severe cough, should be different from simple phlegm or shortness of breath The idea is positive, there is a certain degree of rationality. However, the following problems exist: (1) There are more difficulties and uncertainties according to the type of symptoms; different patients have different sensitivity to symptoms; different patients have different symptoms in the same patient; the pathological changes are mainly classified as airway diseases Emphysema type requires high-resolution CT and pulmonary function as a basis, which