《copd课件》PPT课件

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1、CHRONICOBSTRUCTIVELUNGDISEASE(COPD)CHENGUOZHONGDepartmentofRespiratoryDiseaseDefinitionCOPDisapreventableandtreatablediseasewithsomesignificant（重大的）extrapulmonary（肺外）effectsThechronic慢性的airflowlimitationcharacteristicisnotfullyreversiable可逆的Tobeaprogressivediseaseandtoassociatewith

2、anabnormalinflammatory炎性responseofthelungtonoxious有害的particles微粒orgasesThechronicairflowlimtationofCOPDiscausedbyamixtureofsmallairwaydisease(obstructivebronchiolitis)andparenchymal实质性destruction(emphysema)Epidemiologly病理学COPDisaleadingcauseofmorbidity发病率andmortalitywordwideandresulti

3、naneconomicandsocialburdenCOPDprevalence盛行的,morbidity发病率,andmortality死亡率varyacrosscountriesandacrossdifferentgroupswithincountriesbut,ingeneral,aredirectlyrelatedtotheprevalenceoftobaccosmoking,althoughairpollutionresultingfromtheburningofwoodandotherbiomassfuelshasalsobeenidentifieda

4、saCOPDriskfactorTheprevalenceandburdenofCOPDincreaseinthecomingdecadesduotocontinuedexposure暴露toCOPDriskfactorsandthechangingagestructureCOPDaffectsabout16millionAmericansandisfourthmostcommoncauseofdeathintheUSLessthan6%ofthepopulationinmostnationaldataand8.2%ofadultsover40yearsinchi

5、na21-2Exposuretoparticlesandgases:totalburdenofinhaling吸1.Tobaccosmoke2.Occupationaldusts:organic有机的andinorganic3.Indoorairpollution:fromheatingandcookingwithbiomass生物的inpoorlyventeddwellings4.OutdoorairpullutionFiskfactorsforCOPDGenes:apolygenicdiseasesusceptibility易感性,deficiencyofal

6、pha-1antitrypsinLunggrowthanddevelopmentImbalancebetweenoxidantsandantioxidants,proteasesandantiproteases氧化剂GenderandageRespiratory呼吸的infectionsSocioeconomicstatus社会经济地位NutritionAirwayhyperresponsiveness:asthmaFiskfactorsforCOPDPathogenesis发病机制Chronicinflammationandstructuralchangesre

7、sultingfromrepeatedinjuryandrepair1.Proximal近端airway(﹥2mminternaldiameter)2.Peripheralairway(﹤2mminternaldiameter)3.Lungparenchyma实质(respiratorybronchiolesandalveoli)4.Pulmonaryvasculature血管分布Inflammatorycellsinvolvingmacrophages,neutrophils,andlymphocytesInflammatorymediatorsinvolvin

8、gchem