第6章c子opd.pptVIP

CHRONIC OBSTRUCTIVE LUNG DISEASE (COPD) CHEN GUO ZHONG   Department of Respiratory Disease Definition COPD is a preventable and treatable disease with some significant（重大的） extrapulmonary（肺外） effects The chronic慢性的 airflow limitation characteristic is not fully reversiable 可逆的 To be a progressive disease and to associate with an abnormal inflammatory 炎性response of the lung to noxious有害的 particles微粒 or gases The chronic airflow limtation of COPD is caused by a mixture of small airway disease (obstructive bronchiolitis) and parenchymal 实质性destruction (emphysema) Epidemiologly病理学 COPD is a leading cause of morbidity发病率 and mortality wordwide and result in an economic and social burden COPD prevalence盛行的,morbidity发病率,and mortality死亡率 vary across countries and across different groups within countries but,in general,are directly related to the prevalence of tobacco smoking,although air pollution resulting from the burning of wood and other biomass fuels has also been identified as a COPD risk factor The prevalence and burden of COPD increase in the coming decades duo to continued exposure暴露 to COPD risk factors and the changing age structure COPD affects about 16 million Americans and is fourth most common cause of death in the US Less than 6% of the population in most national data and 8.2% of adults over 40 years in china 21-2 Exposure to particles and gases:total burden of inhaling吸 1.Tobacco smoke 2. Occupational dusts: organic有机的 and inorganic 3. Indoor air pollution: from heating and cooking with biomass生物的 in poorly vented dwellings 4. Outdoor air pullution Fisk factors for COPD Genes: a polygenic disease susceptibility易感性 ,deficiency of alpha-1 antitrypsin Lung growth and development Imbalance between oxidants and antioxidants, proteases and antiproteases氧化剂 Gender and age Respiratory呼吸的 infections Socioeconomic status社会经济地位 Nutrition Airway hyperrespo