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慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)和慢性心力衰竭(chronic heart failure,CHF)的患病率随着年龄增大而增加。在老年患者中,COPD和CHF合并存在十分常见,但是通常被忽视。对于COPD患者,为了避免忽视CHF的存在,也应该常规评估左室功能。同样,对于CHF患者,为了避免忽视COPD的存在,应该常规检查肺功能试验。在COPD的患者中,血浆脑钠肽水平对于诊断合并CHF是有帮助的。骨骼肌代谢变更和萎缩,是导致老年CHF和COPD患者机体能力迅速衰退共同的机制。与传统观念相反,CHF和COPD共存的患者应该给予长期的β受体阻断剂。运动训练可快速逆转骨骼肌代谢更迭和萎缩的进程,促使老年患者独立,并提高生活质量。
The prevalence of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) increases with age. In elderly patients, the co-existence of COPD and CHF is very common, but is often overlooked. In patients with COPD, left ventricular function should be routinely assessed in order to avoid ignoring the presence of CHF. Similarly, in patients with CHF, pulmonary function tests should be routinely checked in order to avoid ignoring the presence of COPD. In patients with COPD, plasma BNP levels are helpful in diagnosing CHF. Changes in skeletal muscle metabolism and atrophy are common mechanisms that lead to the rapid decline of body function in elderly CHF and COPD patients. Contrary to conventional wisdom, patients with CHF and COPD coexistence should be given long-term beta blockers. Exercise training can quickly reverse the process of skeletal muscle metabolic changes and atrophy, to promote independence of elderly patients and improve the quality of life.