西安交通大学医学院呼吸系统疾病课件 Chronic Obstructive Pulmonary Disease.pptVIP

Chronic Obstructive Pulmonary Disease ( COPD ) Interview Chronic obstructive pulmonary disease (COPD) actually comprises two related diseases: chronic bronchitis emphysema one rarely occurring without a degree of the other. The definition of COPD Part 1 Chronic Bronchitis Definition of the diseases Chronic bronchitis is a condition associated with the mucosal inflammation of tracheobronchi and with the mucus overproduction, and it is clinically characterized by cough, expectoration, and/or wheezing for 3 months or more in at least 2 consecutive years in absence of any other disease that might account for the symptoms. Cause and Mechanism 1. Smoking 2. Infection 3. Air pollution and occupational exposure 4.Cold weather 5. Others Hypersensitivity Defense and immunologic function deficiency Old age, heavy smoker, hard working may cause defense and immunologic function deficiency. Pathology Enlarged mucous glands in the large airways, the most characteristic abnormality, is primarily due to increased numbers of their constituent cells (hyperplasia) rather than to enlargement of cells (hypertrophy). Retained bronchial secretions and variable degrees of inflammatory changes in the bronchial walls are also identified. Narrowing or obliteration o some small airways, increased mucus in these airways, and scattered centrilobular emphysema may be found, even though clinically significant obstruction is absent. Clinical Manifestations 1. Symptom 2. Sign Chronic bronchitis can be considered as simple chronic bronchitis with productive cough and asthmatic chronic bronchitis with productive cough and wheezing. It is useful clinically to differentiate between the extremely common simple chronic bronchitis and the less common but often devastating form, chronic asthmatic bronchitis. result of low-grade exposure to bronchial irritants in an individual without hyperreact