【临床医学】蔡映云

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1、Chapterthree?ChronicObstructivePulmonaryDiseases(COPD)?ChronicBronchitis?ObstructivePulmonaryEmphysemaDefinitionofCOPD?Includingchronicbronchitisandpulmonaryemphysema?Chronicairflowlimitation?progressingslowly?Partialreversibility?Abnormalinflammatoryresponseofthelungstonoxiousparti

2、clesorgasesClassificationofCOPDbySeverity?Stage0(atrisk)-Chroniccoughandsputumproduction一Contactwithharmfulfactors-FEVl/FVC>70%?Stage1(mild)-FEVl/FVC<70%-FEV180%predicted-usually,butnotalways,chroniccoughandsputumproductionClassificationofCOPDbySeverity?Stage11(moderate)-IIA:FEVl/FV

3、C<70%50%FEV1<80%predicted-IIB:FEVl/FVC<70%30%FEV1<50%predictedWithorwithoutsymptomClassificationofCOPDbySeverity?Stage111(Severe)-FEVl/FVC<70%-FEV130%predictedorwithrespiratoryfailureorcardiacfailure一.Chronicbronchitis?(——)DefinitionChronicnonspecificinflammationinmucosaanditsperiph

4、eraltissuesoftrachiaandbronchus（二）Etiology?1.Smoking一Epidemicalinformation一Pathologicalexamination一Effectsofgivingupsmoking-Animalexperiment（—）Etiology?2.Airwayinfection一Virus一Bacteria一Mychoplasma（二）Etiology?3.physicalandchemicalfactors一Airpollution一Occupationalcontamination一Indoora

5、ndoutdoorfumes?4.Climate一Coldweather一Variationofatmospherictemperature（二）Etiology?5.Atopy?6.1mmunologicalanddefensivedisturbance?7.Imbalancebetweensympatheticandparasympatheticnervessystems?8.DeficiencyofVitCandA（三）Pathology?Epithelialcells?Mucosaandsubmucosa?Gobletcellsandmucousgla

6、nd?Smoothmuscles?Cartilage?Fibroustissues（四）PathophysiologicalChanges?1.EarlystageAbnormalsmallairwayfunctionCVCCV50V25?2.ObstructiveventilatorydefectFVC

7、ngedexpiration（六）Laboratoryexamination?1.Bloodcellaccount-WBCN%E%?2.Sputum一Bacteria?3.X-rayfilm-Apparentmarkingonbothlowerfields（七）Diagnosis?1.Diagnosticstandard一Productivecoughfor3monthsormoreinatleast2consecutiveyears一Absenceofanyotherdiseasethatmightaccountforthissymptom?2.Type-S

8、imple.Asthmatic?3.S