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COPD,
(760-47)0.21=149.7
0.0sec. 0.25sec. 0.50sec. 0.75sec.
PAO2
PaO2
A-aDO2
80100Torr
15TorrPaO2
PaO2 60 Torr
COPD
CO2
Na
COPD
ARDS
ALS
COPD
COPD
2004
GOLD
GOLD updated
2003
GOLDCOPD
GOLD
(, , )
COPD
GOLD
COPD
GOLD
COPD
1998
1. Heart Disease 724,269 2. Cancer 538,9473. Cerebrovascular disease (stroke) 158,0604. Respiratory Diseases (COPD) 114,3815. Accidents 94,8286. Pneumonia and influenza 93,2077. Diabetes 64,5748. Suicide 29,2649. Nephritis 26,29510. Chronic liver disease 24,936
All other causes of death 469,314
GOLD
10
10.4
COPD
()
WHO
COPD
()
WHO
GOLD
COPD
COPDHRCT
COPD
GOLD
COPD
VC) FVC) FEV1.0
FEV1.0
FVCFEV1.0%
80%
70%
0%
100%
100%
FEV1.0%)
FEV1.0%70%COPD
COPD
FEV1.0
FVCFEV1.0%=
%%FEV1)
% FEV1.0
FEV1.0
COPD%FEV1
COPDF-V
%FEV1
0:
()
I: FEV1/FVC < 70%; %FEV1 80%
II: FEV1/FVC < 70%; 50% %FEV1 < 80%
III: FEV1/FVC < 70%; 30% %FEV1 < 50%
: FEV1/FVC < 70%; %FEV1 < 30% % FEV1< 50%
0:
()
I: FEV1/FVC < 70%; %FEV1 80%
II: FEV1/FVC < 70%; 50% %FEV1 < 80%
III: FEV1/FVC < 70%; 30% %FEV1 < 50%
: FEV1/FVC < 70%; %FEV1 < 30% % FEV1< 50%
GOLD
COPD
COPD
Stage0 Stage Stage Stage Stage
80% 50% 30%%1
COPD
IPF NSIP COP AIP DIP RBILD LIP
IPF
HRCT
honeycomb
HOT
AIPALI/ARDS
ALI: Acute Lung InjuryARDS: Acute Respiratory Distress SyndromeAIP: Acute Interstitial Pneumonia
AIP1. XCT
2. .
3. CRPKL-.
4. ARDS
5. Hamman-Rich.
ALI/ARDS
ARDSALIacute lung injuryALIARDS
ALIARDSPFPaO2/FIO2P/F300ALI200ARDS
ARDS)
PaO2/FiO2200
()
18mmHgor
(Bernard GR1994)
ARDS
ARDS
PEEP 515cmH2O
high PEEP
Permissive hypercapnia
10cmH2O
FOY
COPDCOPDFEV1.0%)%%FEV1)COPDF-VCOPDCOPDIPFAIPALI/ARDS