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慢性阻塞性肺疾病的发病机制(Pathogenesis of chronic obstructive pulmonary disease)
慢性阻塞性肺疾病的发病机制(Pathogenesis of chronic obstructive pulmonary disease)
Pathogenesis of chronic obstructive pulmonary disease; the First Affiliated Hospital of PLA General Hospital; Cui Dejian
Chronic obstructive pulmonary disease (COPD) is characterized by incomplete reversibility and persistent progressive airflow limitation. The pathological basis is the chronic inflammation and structural destruction of the airway wall and lung parenchyma, which eventually leads to the stenosis of airway lumen, the formation of emphysema and the increase of airflow resistance. Airway wall edema, smooth muscle contraction and secretion retention can cause partial reversible airflow limitation. The pathological changes of patients are different, which lead to heterogeneous and different phenotypes. Recent studies have shown that COPD is a systemic disease, and its extrapulmonary manifestations also affect the course of the disease. In the revised 2006 COPD global initiativefor (GOLD), a COPD definition adds the following: COPD is a preventable and treatable disease, has significantly affected the severity of pulmonary disease manifestations. This view broadens the understanding of the nature of COPD and its therapeutic vision. The pathogenesis of COPD is very complex and has not been fully elucidated so far. Several problems in pathogenesis are introduced.
Pathological changes that cause airflow limitation
The characteristic pathological changes of COPD are small airway inflammation and destruction of lung parenchyma. In addition to bronchiolitis and emphysema, large and medium-sized airways also show chronic bronchitis. The latter is mucus glands and goblet cell hyperplasia and squamous metaplasia of epithelial cells, extracellular matrix of type I collagen based submucosal hyperplasia (ECM) and extended to the small airway, elastic fibers rupture, smooth muscle hypertrophy, adventitial fibrosis, the bronchial tree was a continuous inflammatory reaction. The viscosity of secretory m
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