呼吸系统（中英文）课件.pptVIP

Structure and function General Considerations Rapid gas exchange Ventilation Perfusion Diffusion Cleaning the air Alveoli(300 million alveoli in two adult lungs, provide a surface area of some 160 meters square ) Surporting structure Elastic recoil Epithelium Bronchial Submucosal Glands Chronic Obstructive Pulmonary Disease (COPD) 不可逆气道阻塞Irreversible airflow obstruction 慢支和肺气肿Chronic Bronchitis and Emphysema 常常伴发Frequently occur together 与空气污染和吸烟有关Strongly correlated with air pollution and smoking 男多于女More common in men than in women 社会经济影响Socioeconomic impact COPD represents a growing global public health problem. In one population based study conducted at multiple international sites, approximately 10% of participants 40 years of age or older were found to have airflow obstruction of at least moderate severity according to spirometric criteria. ( Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population- based prevalence study. Lancet 2007;370:741-50. ) 我国国家“十五”课题最新统计数据（2005年公布）显示40岁以上人口COPD患病率为8%。估计全国有2500万人罹患此病，每年因COPD死亡的人数达100万，致残人数达500～1000万，COPD居我国疾病负担的首位。 大气道病变 Large airway disease 咳嗽、咳痰Cough and sputum production Histological changes 杯状细胞数量增加 increased numbers of goblet cells in the epithelium 粘液腺数量增加 increased volume of the submucosal mucus glands 慢性炎症a component of chronic inflammation 　　晚期 　　病变向小支气管和细支气管及管壁周围组织扩展，形成细支气管周围炎；管壁增厚管腔闭塞 小细支气管炎 晚期表现 Late stage menifestation 血氧饱和度低 insufficient oxygenation of blood (hypoxemia) 呼吸困难 labored breathing (hypoventilation) 右心衰 right-sided heart failure (cor pulmonale) Pathogenesis 蛋白酶和抗蛋白酶水平失衡 Imbalance between proteases and anti-proteases (alpha-1 antitrypsin) in the lung Cigarette smoking 募集粒细胞和巨噬细胞 Recruits neutrophils and macrophages 氧自由基抑制抗胰蛋白酶 Oxidants and free radicals inhibit the alpha-1-antitrypsin circulating in the lung 慢支和反复感染 Chronic bronchitis and repeated infections 缺乏 Alpha-1 antitrypsin deficiency (1%) 肺