b-臨床常見疾病醫(yī)學英語文獻閱讀馬志方晉建華2014年

WhatisAsthmaisachronicdiseaseoftheairwaysthatmakesbreathingdifficult.Withasthma,thereisinflammationoftheairpassagesthatresultsinatemporarynarrowingoftheairwaysthatcarryoxygentothelungs.Thisresultsinasthmasymptoms,includingcoughing,wheezing,shortnessofbreath,andchesttightness.Somepeoplerefertoasthmaas“bronchialasthma.”Eventhoughthereareseeminglymiraculoustreatmentsforasthmasymptoms,asthmaisstillaserious—evendangerous—diseasethataffectsmorethan25millionAmericansandcausesnearly2millionemergencyroomvisitseveryear.Ineachofthefollowingsections,therearein-deptharticlesthatlinktothetopics.Besuretoreadeachhealthtopicsoyouhaveagreaterunderstandingofasthmaandhowitisdiagnosedandtreated.TherearethreemajorfeaturesofAirwayobstruction.Duringnormalbreathing,thebandsofmusclethatsurroundtheairwaysarerelaxed,andairmovesfreely.Butinpeoplewithasthma,allergy-causingsubstancesandenvironmentaltriggersmakethebandsofmusclesurroundingtheairwaystighten,andaircannotmovefreely.Lessaircausesatofeelshortofbreath,andtheairmovingthroughthetightenedairwayscausesawhistlingsoundknownaswheezing.Inflammation.Peoplewithasthmahaveredandswollenbronchialtubes.Thisinflammationisthoughttocontributegreatlytothelong-termdamagethatasthmacancausetothelungs.And,therefore,treatingthisinflammationiskeytomanagingasthmainthelongrun.Airwayirritability.Theairwaysofpeoplewithasthmaareextremelysensitive.Theairwaystendtooverreactandnarrowduetoeventheslightesttriggerssuchaspollen,animaldander,dust,orfumes.Adult-OnsetAsthmamayoccuratanyage,althoughit’smorecommoninyounger(underagePeoplewhohaveafamilyhistoryofasthmahaveanincreasedriskofdevelothedisease.Allergiesandasthmaoftenoccurtogether.Smokingwithasthma,adangerouscombination,isstillseencommonly.However,anyonecandevelopasthmaatanytime,andadult-onsetasthmahappensfrequently.Ifyouhaveadult-onsetasthma,yourdoctorwillinstructyouinusingtheasthmainhalersandotherasthmamedicationstopreventfurtherbreathingproblems.WhatarethesymptomsofAsthmaischaracterizedbyinflammationofthebronchialtubeswithincreasedproductionofstickysecretionsinsidethetubes.Peoplewithasthmaexperiencesymptomswhentheairwaystighten,inflame,orfillwithmucus.Commonasthmasymptomsinclude:Coughing,especiallyatShortnessofChesttightness,pain,orStill,notevery withasthmahasthesamesymptomsinthesameway.Youmaynothaveallofthesesymptoms,oryoumayhavedifferentsymptomsatdifferenttimes.Yourasthmasymptomsmayalsovaryfromoneasthmaattacktothenext,beingmildduringoneandsevereduringanother.Somepeoplewithasthmamaygoforextendedperiodswithouthavinganysymptoms,interruptedbyperiodicworseningoftheirsymptomscalledasthmaattacks.Othersmighthaveasthmasymptomseveryday.Inaddition,somepeoplemayonlyhaveasthmaduringexerciseorasthmawithviralinfectionslikecolds.Mildasthmaattacksaregenerallymorecommon.Usually,theairwaysopenupwithinafewminutestoafewhours.Severeattacksarelesscommonbutlastlongerandrequireimmediatemedicalhelp.Itisimportanttorecognizeandtreatevenmildasthmasymptomstohelpyoupreventsevereepisodesandkeepasthmaunderbettercontrol.KnowtheEarlySymptomsofEarlywarningsignsarechangesthathappenjustbeforeorattheverybeginningofanasthmaattack.Thesesignsmaystartbeforethewell-knownsymptomsofasthmaandaretheearliestsignsthatyourasthmaisworsening.Ingeneral,thesesignsarenotsevereenoughtostopyoufromgoingaboutyourdailyactivities.Butbyrecognizingthesesigns,youcanstopanasthmaattackorpreventonefromgettingworse.Earlywarningsignsofasthmainclude:Frequentcough,especiallyatSectionTwo:InternalDisease第二部分內(nèi)科疾病LosingyourbreatheasilyorshortnessofFeelingverytiredorweakwhenWheezingorcoughingafterFeelingtired,easilyupset,grouchy,orDecreasesorchangesinlungfunctionasmeasuredonapeakflowSignsofacoldorallergiessneezing,runnynosecoughnasalcongestionsorethroat,andheadache)TroubleIfyouhaveearlywarningsignsorsymptomsofasthma,youshouldtakemoreasthmamedicationasdescribedinyourasthmaactionplan.KnowtheSymptomsofanAsthmaAnasthmaattackistheepisodeinwhichbandsofmusclesurroundingtheairwaysaretriggeredtotighten.Thistighteningiscalledbronchospasm.Duringtheattack,theliningoftheairways esswollenorinflamedandthecellsliningtheairwaysproducemoreandthickermucusthannormal.Allofthesefactors—bronchospasm,inflammation,andmucusproduction—causesymptomssuchasdifficultybreathing,wheezing,coughing,shortnessofbreath,anddifficultyperformingnormaldailyactivities.OthersymptomsofanasthmaattackSeverewheezingwhenbreathingbothinandCoughingthatwon’tVeryrapidChestpainorTightenedneckandchestmuscles，calledDifficultyFeelingsofanxietyorPale,sweatyBluelipsorTheseverityofanasthmaattackcanescalaterapidly,soit5simportanttotreattheseasthmasymptomsimmediayonceyourecognizethem.Withoutimmediatetreatment,suchaswithyourasthmainhalerorbronchodilator,yourbreathingwill emorelabored.Ifyouuseapeakflowmeteratthistime,thereadingwillprobablybelessthan50%.Asyourlungscontinuetotighten,youwillbeunabletousethepeakflowmeteratall.Gradually,yourlungswilltightensothereisnotenoughairmovementtoproducewheezing.Thisissometimescalledthe“silentchest，’，anditisanominoussign.Youneedtobetransportedtoahospitalimmediay.Unfortunay,somepeopleinterpret26.^thedisappearanceofwheezingasasignofimprovementandfailtogetpromptemergencyIfyoudonotreceiveadequateasthmatreatment,youwilleventuallybeunabletospeakandwilldevelopabluishcoloringaroundyourlips.Thiscolorchange,knownascyanosis,meansyouhavelessandlessoxygeninyourblood.Withoutaggressivetreatmentforthisasthmaemergency,youwillloseconsciousnessandeventuallydie.Ifyouareexperiencinganasthmaattack,followthe“RedZone”oremergencyinstructionsinyourasthmaactionplanimmediay.Thesesymptomsoccuriniife-threateningasthmaattacks.Youneedmedicalattentionrightaway.KnowtheAsthmaSymptomsinAsthmaaffectsasmanyas10%to12%ofchildrenintheUnitedStatesandistheleadingcauseofchronicillnessinchildren.Forunknownreasons,theincidenceofasthmainchildrenissteadilyincreasing.Whileasthmasymptomscanbeginatanyage,mostchildrenhavetheirfirstasthmasymptomsbyage5.Notallchildrenwithasthmawheeze.Chroniccoughingwithasthmamaybetheonlyobvioussign,andachild'sasthmamaygounrecognizedifthecoughisattributedtorecurrentbronchitis.KnowAboutUnusualAsthmaNoteveryonewithasthmahastheusualsymptomsofcough,wheezing,andshortnessofbreath.Sometimesindividualshaveunusualasthmasymptomsthatmaynotappeartoberelatedtoasthma.Some“unusual”asthmasymptomsmayincludetherapidinabilitytoexerciseproperly(calledexercise-induceddifficultysleeornighttimedifficultychroniccoughwithoutAlso,asthmasymptomscanbemimickedbyotherconditionssuchasbronchitis,vocalcorddysfunction,andevenheartfailure.It'simportanttounderstandyourbody.Talkwithyourasthmadoctorandotherswithasthma.Beawarethatasthmamaynotalwayshavethesamesymptomsin.KnowWhyInfectionsTriggerAsthmaSometimes orbacterialinfectionisanasthmatrigger.Forinstance,

SectionTwo:Internal—~第二部分內(nèi)科疾mighthaveacold thattriggersyourasthmasymptoms.Oryourasthmacanbetriggeredbyabacterialsinusinfection.Sinusitiswithasthmaiscommon.It’simportanttoknowthesignsandsymptomsofrespiratorytractinfectionsandtocallyourhealthcareproviderimmediayfordiagnosisandtreatment.Forinstance,youmighthavesymptomsofincreasedshortnessofbreath,difficultybreathing,orwheezingwithabronchialinfection.Inpeoplewhodon'thaveasthma,thebronchialinfectionmaynottriggerthesamedebilitatingsymptoms.Knowyourbodyandunderstandwarningsignsthataninfectionmightbestarting.Thentakethepropermedicationsasprescribedtoridtheinfectionandregaincontrolofyourasthmaandhealth.Yourdoctororasthmaspecialistplaysthefirstandmostsignificantroleinyougetcontrolofyourasthma.Notonlydoesyourdoctorserveastheonewhocanaccuraydiagnoseandprescribetreatmentforyourasthma,yourdoctormay eaclose,dependablefriendwhocangiveyousupportwhenyourconcernsturnintoongoingworriesandanxieties.Attheinitialexam,yourdoctorwillobtainadetailedmedicalhistory,includinganyinformationonasthmasymptoms,howyoufeel,knownasthmaandallergytriggers,youractivitylevelanddiet,yourhomeandworkenvironment,andfamilyhistory.Duringthisevaluation,itisimportantthatyoutalkopenlywithyourdoctoraboutyourasthmasymptomsandtriggers.Somequestionsyoumightconsiderbeforehandinclude:ShortnessofWheezing,possiblytriggeredbyallergies,acold,sinusinfection,orFrequentcoughorjustcoughingatSeverewheezingwhenbreathingbothinandRapidChestpainorDifficultyFeelingsofanxietyorPale,sweatyBluelipsorHowisasthmaAftertalkingwithyouaboutyourasthmasymptomsandpossibleasthmatriggers,yourdoctorwilldoaphysicalexam,laboratorytesting,andotherpossibleasthmatests.Thiswillallowyoutohaveafirmunderstandingofyourbreathingproblemsandwillbethebasisforthesuggestedplanofasthmatreatment.Yourdoctormayuseoneormoreofthefollowingasthmatestsindiagnosingasthma.ThesetestsareusedtoassessyourbreathingandtomonitortheeffectivenessofasthmaSpirometryalung(orpulmonary)functiontestthatmeasureshowmuchairyoucanexhale.Thisasthmatestconfirmsthepresenceofairwayobstructionthatimproveswithtreatment,whichisverycharacteristicofasthma,andcanaccuraymeasurethedegreeoflungfunctionimpairment.Thistestcanalsomonitoryourresponsetoasthmamedicationsandis mendedforadultsandchildrenoverage5.PeakFlowTestingaself-assessmentyoucandoathometoevaluatelungfunction.Thepeakexpiratoryflowrate(PEFR)providesareliableobjectivemeasureofairwayfunction.Yourdoctorwillgooverhowtouseapeakflowmeter,whichinvolvestakingadeepbreathandblowingoutashardasyoucan.Peakflowisthehighestairflowvelocitythatyoucanachieve.Whendoneaccuray,adropinthepeakflowmeasurementreflectsanobstructioninyourairways.Whilepeakflowislessaccuratethanofficespirometryformonitoringoflungfunction,peakflowmonitoringathomecanhelpyoumanageyoursymptomsathomeandhelpindicatewhenanasthmaattackmaybeapproaching.ChestX-Raywhilenotroutinelyrequired,iftherearesymptomsthatmaybecausedbyanotherconditionsuchasponia,yourdoctormaywanttodoachestX-ray.Or,ifyourasthmatreatmentisnotworkingaswellasitshould,achestX-raymayhelptoclarifytheproblem.HowisasthmaIfyouoralovedonehasasthma,youshouldknowaboutthemosteffectiveasthmatreatmentsforshort-termreliefandlong-termcontrol.Understandingasthmatreatmentswillenableyoutoworkwithyourasthmadoctortoconfidentlymanageyourasthmasymptomsdaily.Whenyoudohaveanasthmaattackorasthmasymptoms,it'simportanttoknowwhentocallyourdoctororasthmaspecialisttopreventanasthmaemergency.Besuretoreadallthein-deptharticlesthatlinktotopicswithineachofthefollowingsections.Byngso,youwillgainnewinsightintoasthmaandhowit’streated.AsthmaAsthmamedicationscansaveyourlife—andletyouliveanactivelifeinspiteofyourasthma.Therearetwobasictypesofdrugsusedinasthmatreatment.SteroidsandOtherAnti-InflammatoryAnti-inflammatorydmgs,particularlyinhaledsteroids,arethemostimportanttreatmentformostpeoplewithasthma.Theselifesavingmedicationspreventasthma

SectionTwoInternal—w第二部分內(nèi)科疾attacksandworkbyreducingswellingandmucusproductionintheairways.Asaresult,theairwaysarelesssensitiveandlesslikelytoreacttoasthmatriggersandcauseasthmaBronchodilatorsandBronchodilatorsrelievethesymptomsofasthmabyrelaxingthemusclesthatcantightenaroundtheairways.Thishelpstoopenuptheairways.Short-actingbronchodilatorinhalersareoftenreferredtoasrescueinhalersandareusedtoquicklyrelievethecough,wheeze,chesttightness,andshortnessofbreathcausedbyasthma.Theymayalsobeusedpriortoexerciseforpeoplewithexercise-inducedasthma.Theseshouldnotbeuseddailyintheroutinetreatmentofasthma.Ifyouneedtouseashort-actingbronchodilatorasarescueinhalermorethantwiceaweek,thenyourasthmaisnotoptimallycontrolled.Askyourdoctoraboutimprovingyourasthmacontrollermedication.Long-actingbronchodilatorsareusedincombinationwithinhaledsteroidsforcontrolofasthmasymptomsorwhensomeonehasongoingasthmasymptomsdespitetreatmentwithadailyinhaledsteroid.Long-actingbronchodilatorsareneverusedaloneaslong-termtherapyforasthma.AsthmaAsthmainhalersarethemostcommonandeffectivewaytodeliverasthmadrugstothelungs.Theyareavailableindifferenttypesthatrequiredifferenttechniquesforuse.Someinhalersdeliveronemedicationandotherscontaintwodifferentmedications.AsthmaIfyou'rehavingdifficultyusingsmallinhalers,yourdoctormayprescribeanasthmanebulizer,alsoknownasabreathingmachine.Theasthmanebulizerusesamouthpieceormaskandistypicallyusedforinfants,smallchildren,olderadults,oranyonewhohasdifficultyusinginhalerswithspacers.Thenebulizerchangesasthmamedicationsfromaliquidtoamist,sothattheycanbemoreeasilyinhaledintothelungs.Thistakesafewmoreminutesthanusinginhalers.PrednisoneandAsthmaIfyouhaveaseriousasthmaattack(exacerbation),yourdoctormayprescribeashortcourseoforalcorticosteroids.Whenusedorallyforlessthantwoweeks,thesideeffectsofcorticosteroidsareonlytemporary,butwhenusedformanymonths,thesesideeffectscanbeseriousandpermanent.Aftertheseveresymptomsofyourasthmaattackhavebeensuccessfullytreatedandcontrolled,yourdoctorwillworkwithyoutominimizeyourneedforprednisoneinthefuture.Faithfullytakinganinhaledcorticosteroideverydayisthemostcommonlysuccessfulmethodtodothis.匯allergy'aela^dsin.過敏癥asthma[’aezman.哮喘bronchospasm[’brDfikaspaezam]n.支氣管疫攣cyanosis[.saia'nosis]n.發(fā)甜debilitate[di’bmteit]vt.使衰弱，使虛弱escalate[’eskaleitvi/vt.逐步增強exacerbation[ek.saesa’beij^n]n.exhale[sks'hel】vi?呼氣，呼出grouchy[’graut/iadj.不高興，不滿的incidence['insidans】n.inhale[in’hel]vi.吸入，吸氣irritability[jrata’bilatin.過敏性，興奮性mimicked[mimikt]v.模仿miraculous[mi'raekjalasadj.不可思議的mist[mist]n.薄霧moody['mudiadj.郁郁寡歡nebulizer[’nebja.laiza^】n.噴霧劑，噴霧器ominous[’aminas]adj.預兆的；不吉利的optimally['aptamali]adv?最佳；最適宜地panic['paenik】n.，驚恐pollen[’palan】n?花粉prednisone[’prednizaunn.強的松sinusitis[,saina’saitis】n.鼻竇炎airwayobstruction氣道梗阻bronchialasthma支氣管哮喘peakexpiratoryflowratePEFR)最大呼氣流速vocalcord聲帶

Disease(COPD)WhatisCOPD,orchronicobstructivepulmonarydisease,isalong-termlungdiseasethatreferstobothchronicbronchitisandemphysema.WhatcausesCOPDismostoftencausedbysmoking.MostpeoplewithCOPDarelong-termsmokers,andresearchshowsthatsmokingcigarettesincreasestheriskofgettingCOPD:Outofevery100long-termsmokers,about15to20getCOPDwithsymptoms.Thatmeansthatabout80to85outof100donotgetCOPDwithsymptoms. Somestudiesshowthatuptohalfoflong-termsmokersolderthanage60getSmokingbothtobaccoandmarijuanaincreasestheriskofCOPDmorethansmokingeitherone.COPDisoftenamixoftwodiseases:chronicbronchitisandemphysema.Bothofthesediseasesarecausedbysmoking.Althoughyoucanhaveeitherchronicbronchitisoremphysema,peoplemoreoftenhaveamixtureofbothdiseases.ChronicAlmostallpeoplewithchronicbronchitisare,orhavebeen,tobaccosmokers.Overtime,tobaccosmokeandotherlungirritantscanleadtoinflammationintheairwaysofthelungs(bronchialtubes).Asaresult,theairwaysproducemoremucusthantheynormallywould.Inflammationandexcessmucuscausecoughingandnarrowtheairways.Itishardtobreathethroughthenarrowairways,soyoufeelshortofbreath.Long-term(chronic)mucusproductionandinflammationovermanyyearsmayleadtopermanentlungdamageandmaymakeitmorelikelythatyouwillgetlunginfections.Inemphysema,tobaccosmokeandotherirritantscandamagetheelasticfibersinthelungs.Thesestretchystrandsoftissueareneededfornormallungfunction.Theyallowthelungtissuetostretchwhenyoubreatheinandhelppullthelungsbacktotheirnormalsizeandshapeasyoubreatheout.Whentheelasticfibersaredamaged:Thetinyairsacs(alveoli)attheendofthebronchialtubesaredamaged.Theseairsacsarewherethebloodexchangescarbondioxide(aby-productofmetabolism)foroxygen.Whenairsacsaredamagedordestroyed,theirwallsbreakdownandthesacs elarger.Theselargeairsacsmovelessoxygenintotheblood.Afterairsacsaredestroyed,theycannotbereplaced.Thesmallerairwaysinthelungs(bronchioles)tendtocollapsewhenyoubreatheout,trapairinthealveoli.Asaresult,oxygen-richairhastroubleenteringtheairsacs.Andcarbondioxidehasahardertimegettingoutofthelungs.SeepicturesofbronchitisandInchronicbronchitis,exposuretotobaccosmokeandotherlungirritantsovertimecanleadtoinflammationintheairwaysthatdeliverairintothelungs(bronchialtubes).Asaresult,theairwaysproducemoremucusthantheywouldnormally.Inflammationandextramucusreduceairflowandcausecoughing.Mucusproductionandinflammationovermanyyearsmayleadtoprogressiveandpermanentlungdamage.Emphysemaisalong-term(chronic)lungdisease.Inemphysema,thetinyairsacs(alveoli)attheendoftheairwaysinthelungsaredamaged.Whentheairsacsaredamagedordestroyed,theirwallsbreakdownandthesacs elarger.Theselargerairsacsmovelessoxygenintotheblood.Thiscausesdifficultybreathingorshortnessofbreaththatgetsworseovertime.Afterairsacsaredestroyed,theycannotbereplaced.Emphysemaisaformofchronicobstructivepulmonarydisease(COPD).Itisusuallycausedbysmoking.Araretypeofemphysemaiscausedbythelackofasubstanceinthelungscalledalpha1-antitrypsin.Thistypeofemphysemaisusuallyinherited.OtherOtherpossiblecausesofCOPDLong-termexposuretolungirritantssuchasindustrialdustandchemicalPretermbirththatleadstolungdamage(neonatalchroniclungInheritedfactors(genes),includingalpha-1antitrypsindeficiency,arareconditioninwhichyourbodymaynotbeabletomakeenoughofaprotein(alpha-1antitrypsin)thathelpsprotectthelungsfromdamage.Peoplewhohavethisdisorderandwhosmokegenerallystarttohavesymptomsofemphysemaintheir30sor40s.Thosewhohavethisdisorderbutdonotsmokegenerallystarttohavesymptomsintheir80s.WhatarethesymptomsofWhenyouhaveYouhaveacoughthatwon’tgoYouoftencoughupYouareoftenshortofbreath,especiallywhenyouCOPDManypeoplewithCOPDhaveattackscalledflare-upsorexacerbations(sayt4egg-ZASS-er-BAY-shuns”).Thisiswhenyourusualsymptomsquicklygetworseandstayworse.ACOPDflare-upcanbedangerous,andyoumayhavetogotothehospital.SymptomsCoughingupmoremucusthanAchangeinthecolororthicknessofthatMoreshortnessofbreaththanTheseattacksaremostoftencausedbyinfections-suchasacutebronchitisandponia-andairpollution.WorkwithyourdoctortomakeaplanfordealingwithaCOPDflare-up.Ifyouareprepared,youmaybeabletogetitundercontrol.Trynottopanicifyoustarttohaveone.Quicktreatmentathomemayhelpyoumanageseriousbreathingproblems.ThestagesofThestagesofCOPDareoftendefinedaccordingtoyoursymptomsplusameasureofhowwellyourlungswork,calledyour“l(fā)ungflinction”.Inthefollowingsymptomslists,lungfunctionFEV1isatestresultthatshowshowfastyoucanbreatheairoutofyourlungs.FEV1standsforforcedexpiratoryvolumein1FEV1canbemeasuredbymachinescalledspirometers.Thetestresultisreportedasapercentageofnormal.Inotherwords,anFEV1of100%meansthelungsareworkingnormally;80%islessthannormal;30%isverymuchlessthannormal.HereishowthestagesofCOPDaredescribedbytheGlobalInitiativeforChronicObstructiveLungDisease.MildCOPD(stageUsually,butnotalways,achroniccoughthatoftenbringsupmucusfromthelungsLungfunctionFEV1of80%ofnormalorhigherModerateCOPD(stageChroniccoughwithalotofmucusShortnessofbreath,especiallywithexerciseAnoccasionalCOPDflare-upLungfunctionFEV1of50%toSevereCOPD(stageChroniccoughwithalotofShortnessofFatigueandareducedabilitytoexerciseRepeatedandsometimessevereCOPDflare-upsLungfunctionFEV1of30%to49%VerysevereCOPD(stageChroniccoughwithalotofmucusSevereshortnessofbreathWeightBlueskincolor,especiallyinthelips,fingers,andtoes(calledcyanosis)Fluidbuildupinthelegsandfeet(callededema)Life-threateningCOPDflare-LungfunctionFEV1oflessthan30%,oroflessthan50%alongwithchronicrespiratoryfailure(aconditioncausedbycarbondioxidethatstaysinthelungs)ConditionswithsimilarsymptomsConditionswithsymptomssimilartoCOPDHeartCoronaryarteryAsthma.SomepeoplewithCOPDmayhaveasthmatoo.Butthetwoconditionsdifferinanumberofways,includinghowoldyouarewhenyougetthediseaseandwhattriggersanattack.CysticPulmonary HowtodiagnoseTodiagnoseCOPD,dothefollowingMedicalhistoryandphysicalexam.Thesewillgiveyourdoctorimportantinformationaboutyourhealth.Lungfunctiontests.Thesemeasuretheamountofairinyourlungsandthespeedatwhichairmovesinandout.Spirometryisthemostimportantofthesetests.ChestX-ray.Thishelpsruleoutotherconditionswithsimilarsymptoms,suchaslungcancer.TestsdoneasArterialbloodgastest.Thistestmeasureshowmuchoxygen,carbondioxide,andacidisinyourblood.IthelpsyourdoctordecidewhetheryouneedoxygenOximetry.Thistestmeasurestheoxygensaturationintheblood.Itcanusefulinfindingoutwhetheroxygentreatmentisneeded,butitprovideslessinformationthanthearterialbloodgastest.Electrocardiogram(ECG,EKG)orechocardiogram.Thesetestsmayfindcertainheartproblemsthatcancauseshortnessofbreath.Transferfactorforcarbonmonoxide.Thistestlooksatwhetheryourlungshavebeendamaged,andifso,howmuchdamagethereisandhowbadyourCOPDmightbe.TestsrarelyAtesttomeasurelevelsofalpha-1antitrypsin,orATT.ATTisaproteinyourbodymakesthathelpsprotectthelungs.Peoplewhosebodiesdon'tmakeenoughATTaremorelikelytogetemphysema.ACTscan.ThisgivesdoctorsadetailedpictureoftheRegularBecauseCOPDisadiseasethatkeepsgettingworse,itisimportanttoscheduleregularcheckupswithyourdoctor.Checkupsmayinclude:ArterialbloodgasX-raysorlyourdoctoraboutanychangesinyoursymptomsandwhetheryouhavehadanyflare-ups.Yourdoctormaychangeyourmedicinesbasedonyoursymptoms.EarlyThesoonerCOPDisdiagnosed,thesooneryoucantakestepstoslowdownthediseaseandkeepyourqualityoflifeforaslongaspossible.ScreeningtestshelpyourdoctordiagnoseCOPDearly,beforeyouhaveanysymptoms.TalktoyourdoctoraboutCOPDscreeningifAreasmokerorex-Havehadseriousasthmasymptomsforalongtime,whichhavenotimprovedwithtreatment.HaveafamilyhistoryofHaveajobwhereyouareexposedtoalotofchemicalsorTheU.S.PreventiveServicesTaskForce(USPSTF)doesnot mendCOPDscreeningforadultswhoarenotathighriskofdeveloCOPD.HowisitAlthoughCOPDcannotbecured,itcanbemanaged.ThegoalsoftreatmentareSlowdownthediseasebyavoidingtobaccosmokeandairLimityoursymptomssuchasshortnessofIncreaseyouractivityImproveyouroverallPreventandtreatflare-ups.Aflare-up,orexacerbation,iswhenyoursymptomsquicklygetworseandstayworse.ManypeopleareabletomanagetheirCOPDwellenoughtotakepartintheirusualdailyactivities,hobbies,andfamilyevents.InitialAtfirst,treatmentforCOPDhelpsyoubreathebetterandslowthedisease.Muchofthetreatmentincludesthingsyoudoforyourself:Quitsmoking.Thisissoimportant.Andit'snevertoolate.NomatterhowlongyouhavehadCOPDorhowseriousitis,quittingsmokingwillhelpslowdownthediseaseandimproveyourqualityoflife.TodayJsmedicinesofferlotsofhelpforpeoplewhowanttoquit.Youwilldoubleyourchancesofquittingevenifmedicineistheonlytreatmentyouusetoquit,butyouroddsgetevenbetterwhenyoucombinemedicineandotherquitstrategies,suchascounseling.Stayactive.Ifyoustayactive,youmayhavelessshortnessofbreath,haveabetterattitudeaboutyourlifeandthedisease,andbelesslikelytofeeldepressedorisolatedfromfriendsandfamily.Exerciseimprovesshortnessofbreathandwillhelpyoubemoreactive.MedicineforCOPDisusedReduceshortnessofControlcoughingandPreventCOPDflare-ups,alsocalledexacerbations,orkeeptheflare-upsyoudohavefrombeinglife-threatening.MostpeoplewithCOPDfindthatmedicinesmakebreathingSomeCOPDmedicinesareusedwithdevicescalledinhalersornebulizers.Most mendusingspacerswithinhalers.It’simportanttolearnhowtousethesedevicescorrectly.Manypeopledon’t,sotheydon’tgetthefiillbenefitfromtheLungsurgeryisrarelyusedtotreatCOPD.SurgeryisneverthefirsttreatmentchoiceandisonlyconsideredforpeoplewhohavesevereCOPDthathasnotimprovedwithotherSurgeryLungvolumereductionsurgery:Removespartofoneorbothlungs,1820roomfortherestofthelungtoworkbetter.ItisusedonlyforsevereLungtransplant:Replacesasicklungwithahealthylungfroma whohasjustdied.Bullectomy:Removesthepartofthelungthathasbeendamagedbytheformationoflarge,air-filledsacscalledbullae.Thissurgeryisrarelydone.匯 的；初生的preterm[pri:'t3:mn.早產(chǎn)spirometer[spai'rDmitan.bronchialtube支氣管chronicbronchitis慢性支氣chronicobstructivepulmonarydisease(COPD)慢性阻塞性肺病cysticfibrosis囊胞性纖維癥elasticfibers彈性纖維forcedexpiratoryvolume用力呼氣量；強力呼氣容積oxygensaturation氧飽和；氧飽和度pulmonaryfibrosis肺纖維化許召良馬志 WhatispPoniaisalunginfectionthatcanmakeyouverysick.Youmaycough,runafever,andhaveahardtimebreathing.Formostpeople,poniacanbetreatedathome.Itoftenclearsupin2to3weeks.Butolderadults,babies,andpeoplewithotherdiseases everyill.Theymayneedtobeinthehospital.Onecangetponiainhisdailylife,suchasatschoolorwork.Thisiscalledcommunity-associatedponia.Onecanalsogetitwhenheisinahospitalornursinghome.Thisiscalledhealthcare-associatedponia.Itmaybemoreseverebecausehealreadyisill.Whatcausespes,bacteria,or(inrarecases)parasitesorotherorganismscancauseInmostcases,thespecificorganism(suchasbacteriaor)cannotidentifiedevenwithtesting.Whenanorganismisidentified,itisusuallythebacteriastreptococcusponiae.Manytypesofbacteriamaycauseponia.Poniacausedmycoplasmaponiaeissometimesmildandcalled“walkingpes,suchasinfluenzaA(theflu)andrespiratorysyncytial(RSV)cancauseponia.Inpeoplewithimpairedimmunesystems,poniamaybecausedbyotherorganisms,includingsomeformsoffungi,suchasPocystisjiroveci(formallycalledPocystiscarinii).Thisf