copd英文课87页PPT

Chronic Bronchitis
Clinical manifestation
Character: ➢ chronic onset, recurrent attack and long
course of disease Main symptoms: ➢ cough: chronic, long term, repeatedly ➢ expectoration: mucoid sputum, purulent
Sputum examination: bacterial culture guide antibiotic treatment
Diagnosis
Chronic cough and sputum production for 3 consecutive months in at least 2 successive years（≥3m/yⅹ2y）, excluding other chronic lung diseases (TB, Bronchiectasis )
Examination Chest x-ray imaging
Examination
Pulmonary function test: maybe normal in early stage. Gradually obstructive airway function appeared.
Blood routine: elevated neutrophil or eosinophil
Relationship of COPD and Chronic bronchitis, Asthma or Emphysema
Chronic Bronchitis
Chronic Bronchitis
Definition: Chronic and unspecific inflammation of bronchi and the surrounding tissue.
Percent Change in Age-Adjusted Death Rates, U.S., 1965-2019
Proportion of 1965 Rate
3.30.0 2.25.5
Coronary Heart
Disease
Stroke
2.20.0
Other CVD
COPD
All Other Causes
The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking.
Definite chest imaging or lung function
Typing
Typing : 1、simple：cough, sputum 2、wheezing：with wheezing (actually
Chronic bronchitis plus asthma)
Emphysema
Definition
Emphysema is characterized by enlargement and destruction of respiratory bronchioles and /or alveoli in the lungs.
Etiology
Environment Factors ✓ Cigarette smoking ✓ Occupational dusts and chemicals ✓ Infections Host Factors ✓ Genes: Alpha1-antitrypsin deficiency
Feature: chronic mucus hypersecretion and cough.
Morbidity: 3.2% in population over 15 y，up to 15% in elderly over 50 y.
Etiology and mechanism
Environment Factors ✓ Cigarette smoking ✓ Occupational dusts and chemicals ✓ Infections Host Factors ✓ Genes ✓ Lung growth and defense mechanism
It is expected to be the third leading cause of death by 2020
Approximately 3% Chinese above 15 are currently suffering from COPD
Definition
COPD is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible.
sputum when infection ➢ wheezing: seen in some patients
Clinical manifestation
Sign: 1. no obvious sign in early stage 2. sometimes moist rales and rhonchi
1.15.5
1.10.0
0.05.5
0.0 0
–59%
–64%
–35%
Hale Waihona Puke +163%–7%
1965 - 2019 1965 - 2019 1965 - 2019 1965 - 2019 1965 - 2019
Why COPD is Important ?
COPD is the only chronic disease that is showing progressive upward trend in both mortality and morbidity