内科学课件：02 COPD肺心病-八年制
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Those who demonstrate a progressive decline in airflow have chronic obstructive bronchitis, which constitutes the majority of patients with COPD.
etiology
Exacerbations and comorbidities contribute to the overall severity in individual patients
General concept
The chronic airflow limitation characteristic of COPD is caused by a mixture of small airway
Predicted Mortality of COPD
1990
Ischemic heart D 1
Cerebrovascular D 2
LRTI
3
Diarrhae
4
Perinatal D 5
COPD
6
2020
Ischemic heart D 1 Cerebrovascular D 2
COPD
3
LRTI
Pulmonary hypertension肺动脉高压 Chronic Cor Pulmonale慢性肺源性心脏病
General concept
COPD, a common preventable and treatable disease
is characterized by persistent airflow limitation that is usually progressive and associated with enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.
Cough Sputum expectoration
Cough Sputum expectoration Gasping
Stages of Chronic Bronchitis
Stages
Exacerbation
Time Courses
In a week
Chronic lag phase
stable
Smoking Air pollution Infection Climate Internal factor
© 2004 Prous Science. All rights
reserved.
Clinical features
Symptoms: cough, expectorateon of sputum, wheezing
3
Lung cancer
5
Traffic Accident 4
GOLD Report 2006.p11
CHRONITIS BRONCHITIS
Definition
Chronic bronchitis is a clinical diagnosis based on the symptoms of chronic cough and sputum production.
disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), the
relative contributions of which vary from person to person.
Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998
Chronic Obstructive Pulmonary Disease(COPD)
Chronic Cor Pulmonale 慢性阻塞性肺病 慢性肺源性心脏病
General introduction
COPD慢性阻塞性肺病
Chronic bronchitis慢性支气管炎、Emphysema肺气肿
One month or longer Lasts for two months
Lab testing
CXR
PFT
Sputum bacteria culture
Blood testing
Diagnosis
Clinical diagnosis: Symptoms persisting 3 mons/yr Lasting for 2 consective yrs Exclude other lung and heart disease If shorter than three months /per year
Signs: moist and dry rales, rhonchi
Classification of Chronic Bronchitis
Simple type of Chronic Bronchitis
(without gasping)
Chronic Bronchitis with
gasping
It is defined as persistence of cough and excessive mucus secretion on most days over a 3-month period for at least 2 successive years.
Definition
Patients who have chronic productive cough and normal airflow are diagnosed as having simple chronic bronchitis;
Proportion of 1965 Rate
3.30.0 2.25.5
CoronarLeabharlann Baidu Heart
Disease
Stroke
2.20.0
Other CVD
COPD
All Other Causes
1.15.5
1.10.0
0.05.5
0.0 0
–59%
–64%
–35%
+163%
–7%
1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998
etiology
Exacerbations and comorbidities contribute to the overall severity in individual patients
General concept
The chronic airflow limitation characteristic of COPD is caused by a mixture of small airway
Predicted Mortality of COPD
1990
Ischemic heart D 1
Cerebrovascular D 2
LRTI
3
Diarrhae
4
Perinatal D 5
COPD
6
2020
Ischemic heart D 1 Cerebrovascular D 2
COPD
3
LRTI
Pulmonary hypertension肺动脉高压 Chronic Cor Pulmonale慢性肺源性心脏病
General concept
COPD, a common preventable and treatable disease
is characterized by persistent airflow limitation that is usually progressive and associated with enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.
Cough Sputum expectoration
Cough Sputum expectoration Gasping
Stages of Chronic Bronchitis
Stages
Exacerbation
Time Courses
In a week
Chronic lag phase
stable
Smoking Air pollution Infection Climate Internal factor
© 2004 Prous Science. All rights
reserved.
Clinical features
Symptoms: cough, expectorateon of sputum, wheezing
3
Lung cancer
5
Traffic Accident 4
GOLD Report 2006.p11
CHRONITIS BRONCHITIS
Definition
Chronic bronchitis is a clinical diagnosis based on the symptoms of chronic cough and sputum production.
disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), the
relative contributions of which vary from person to person.
Percent Change in Age-Adjusted Death Rates, U.S., 1965-1998
Chronic Obstructive Pulmonary Disease(COPD)
Chronic Cor Pulmonale 慢性阻塞性肺病 慢性肺源性心脏病
General introduction
COPD慢性阻塞性肺病
Chronic bronchitis慢性支气管炎、Emphysema肺气肿
One month or longer Lasts for two months
Lab testing
CXR
PFT
Sputum bacteria culture
Blood testing
Diagnosis
Clinical diagnosis: Symptoms persisting 3 mons/yr Lasting for 2 consective yrs Exclude other lung and heart disease If shorter than three months /per year
Signs: moist and dry rales, rhonchi
Classification of Chronic Bronchitis
Simple type of Chronic Bronchitis
(without gasping)
Chronic Bronchitis with
gasping
It is defined as persistence of cough and excessive mucus secretion on most days over a 3-month period for at least 2 successive years.
Definition
Patients who have chronic productive cough and normal airflow are diagnosed as having simple chronic bronchitis;
Proportion of 1965 Rate
3.30.0 2.25.5
CoronarLeabharlann Baidu Heart
Disease
Stroke
2.20.0
Other CVD
COPD
All Other Causes
1.15.5
1.10.0
0.05.5
0.0 0
–59%
–64%
–35%
+163%
–7%
1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998