慢性阻塞性肺疾病急性加重诊治中国专家共识(2023年修订版)

·132·回际呼吸杂志2023年2月第43卷第2期1 nt J Respir,February2023,Vcl.43,No.2·指南与共识·慢性阻塞性肺疾病急性加重诊治中国专家共识(2023年修订版)慢性阻塞性肺疾病急性加重诊治专家组通信作者：蔡柏蔷，Email:caibq2009@hotmail.com;阁锡新，Email:xi-xin-yan@163.com【摘要】慢性阻塞性肺疾病急性加重(AECOPD)是慢性阻塞性肺疾病患者死亡与疾病进展的主要诱因，AECOPD诊治专家组依托近4年来相关文献，第4次更新了共识核心内容，提出AECOPD新的定义、严重程度分级与分级诊疗方案，细化了抗菌药物经验性选择建议，对支气管舒张剂及糖皮质激素的使用、呼吸支持与氧疗策略等方面也进行了更新调整，【关键词】肺疾病，慢性阻塞性，急性加重，专家共识基金项目：河北省省级科技计划资助(22377714D)D0I:10.3760/cma.j.cn131368-20221123-01066Expert consensus on the acute exacerbation of chronic obstructive pulmonary disease in China (revisionin2023)Expert group on management of acute exacerbation of chronic obstructive pulmonary diseaseCorres ponding author:Cai Baigiang,Email:caibg2009@hotmail.com:Yan Xixin,Email:xi_xin_yan@163.0m1915[Abstract]Acute exacerbation of chronic obstructive pulmonary disease (AECOPD)is themain cause of death and disease progression in patients with chronic obstructive pulmonary disease(COPD).Through literature review within the past 4 years,the Expert Group on the Managementof Acute Exacerbation of Chronic Obstructive Pulmonary Disease has revised and updated the corecontents of the consensus for the fourth time,which has proposed the new definition of AECOPD,and the classification of the severity and corresponding graded diagnosis and treatment regimens.Inparticular,the empirical selection of antimicrobial agents,and the use of bronchodilators andglucocortiooids have been more specific,and respiratory support and oxygen therapy strategies havebeen modified as well.[Key words]Pulmonary disease,chronic obstructive;Acute exacerbation;Expert consensusFund program:Hebei Provincial Science and Technology Program (22377714D)D0I:10.3760/cma.j.cn131368-20221123-01066慢性阻塞性肺疾病（简称慢阻肺）是一种异人。慢阻肺患者每年发生0.5~3.5次急性加重，是质性肺部病变，其特征是慢性呼吸系统症状（呼吸慢阻肺患者的首位死亡因素。2013年我国慢阻肺困难、咳嗽、咳痰)，原因与气道异常（支气管炎、总死亡人数为91万，单病种排名第三，占全球慢细支气管炎)和（或）肺泡异常（肺气肿）相关，阻肺死亡总人数的31.1%。其影响因素众多，也通常表现为持续性、进行性加重的气流阻塞四。慢与早期防控和规范化治疗不到位密切相关)。阻肺是我国最常见的慢性呼吸系统疾病，患病率慢性阻塞性肺疾病全球倡议(global initiative高，疾病负担重。2o18年王辰院士牵头的“中国for chronic obstructive lung disease,GOLD)指肺部健康研究”显示我国40岁以上人群中慢阻肺出，由于慢阻肺危险因素的持续存在和人口老龄发病率达13.7%，较钟南山院士2007年报道的化，其经济负担将逐年增加)，慢性阻塞性肺疾病8.2%可高出5.5%。全国慢阻肺总患病人数约1亿急性加重(acute exacerbation of chronic obstructive