临床医学蔡映云慢支肺气肿课件

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1、ChapterthreeChronicObstructivePulmonaryDiseases(COPD)ChronicBronchitisObstructivePulmonaryEmphysemaDefinitionofCOPDIncludingchronicbronchitisandpulmonaryemphysemaChronicairflowlimitationprogressingslowlyPartialreversibilityAbnormalinflammatoryresponseo

2、fthelungstonoxiousparticlesorgasesClassificationofCOPDbySeverityStage0(atrisk)ChroniccoughandsputumproductionContactwithharmfulfactorsFEV1/FVC>70%StageI(mild)FEV1/FVC<70%FEV1≥80%predictedusually,butnotalways,chroniccoughandsputumproductionClassificatio

3、nofCOPDbySeverityStageII(moderate)IIA:FEV1/FVC<70%50%≤FEV1<80%predictedIIB:FEV1/FVC<70%30%≤FEV1<50%predictedWithorwithoutsymptomClassificationofCOPDbySeverityStageIII(Severe)FEV1/FVC<70%FEV1≤30%predictedorwithrespiratoryfailureorcardiacfailure一.Chronic

4、bronchitis(一)DefinitionChronicnonspecificinflammationinmucosaanditsperipheraltissuesoftrachiaandbronchus（二）Etiology1.SmokingEpidemicalinformationPathologicalexaminationEffectsofgivingupsmokingAnimalexperiment（二）Etiology2.AirwayinfectionVirusBacteriaMyc

5、hoplasma（二）Etiology3.physicalandchemicalfactorsAirpollutionOccupationalcontaminationIndoorandoutdoorfumes4.ClimateColdweatherVariationofatmospherictemperature（二）Etiology5.Atopy6.Immunologicalanddefensivedisturbance7.Imbalancebetweensympatheticandparasy

6、mpatheticnervessystems8.DeficiencyofVitCandA（三）PathologyEpithelialcellsMucosaandsubmucosaGobletcellsandmucousglandSmoothmusclesCartilageFibroustissues(四)PathophysiologicalChanges1.EarlystageAbnormalsmallairwayfunctionCVCCV50V252.Obstructiveventilatoryd

7、efectFVC

8、ds(七)Diagnosis1.DiagnosticstandardProductivecoughfor3monthsormoreinatleast2consecutiveyearsAbsenceofanyotherdiseasethatmightaccountforthissymptom2.TypeSimple,Asthmatic3.StageAcuteexacerbation,Chronicstage,Remission(八)Differentialdiagnos