天津医科大学内科学课件 COPD（一）.pptVIP

A 65y man Chronic cough ,sputum for 20 years. short of breath 8 years, Smoke 40 years,20 cig/d Barrel chest coarse crackles/ scattered wheezes COPD Chronic Obstructive Pulmonary Disease key points Chronic Obstructive Pulmonary Disease is a preventable and treatable disease with some significant extrapulmonary effects. The pulmonary component is characterized by airflow limitation that is not fully reversible. Chronic Obstructive Pulmonary Disease (COPD) The airflow limitation in COPD is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles and gases Severe COPD leads to respiratory failure, hospitalization and eventually death from suffocation Why was GOLD Started? The social and economic burden of COPD is increasing rapidly in countries at all levels of economic development COPD is under-appreciated, under-diagnosed and under-treated Important questions about COPD are still unanswered COPD Prevalence Rate (adjusted)* in Population ? 40 years COPD Prevalence Survey (NICE) in Japan COPD Mortality Worldwide Why is COPD Increasing Worldwide? Increase in exposure to risk factors (especially tobacco) in developing countries in women Changing demographics globally with more of the population, especially in the developing countries living into the COPD age range Definition of chronic bronchitis Cough, Sputum , asthma or Short -ness of breath At least 3 months annually during 2 or more successive years Exclusion of other disease Definition of emphysema characterized by abnormal, permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of their walls, and without obvious fibrosis. The alterations in emphysema reduce lung elastic recoil, which permits excessive airway collapse upon expiration and leads to irreversible airflow obstruction. Pathology Enlarged mucous glands Retained bronchial secretions Inflammatory changes in the bro