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一、慢性阻塞性肺部疾病(Chronic Obstructive Pulmonary Direase;COPD)的定义与范畴COPD是多种因素引起的以气道阻塞为共同特征的临床综合征。过去认为COPD是慢性支气管炎、肺气肿、支气管哮喘和肺心病等的总称。近年来研究认为,上述各种疾病的病理生理和不同阶段的支气管高反应性各不相同,所以1983年Burrows等提出COPD仅包括那些呈不可逆性气道阻塞的慢性肺部疾病,慢性支气管炎、肺气肿、支气管哮喘等;即伴有持续性广泛的气道狭窄,虽经支气管扩张剂(包括皮质激素)治疗仍不能恢复正常者称之为COPD。慢性支气管炎有单纯支气管炎和阻塞性支气管炎两种。两者在发病机制和预后有明显差异。前者病变主要在大支气管,少有发展成气道阻塞。后者多数病变起始于小气道,极易造成气道狭窄。肺气肿分为阻塞性肺气肿和非阻塞性肺气肿。阻塞性肺
First, the definition and scope of chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Directed; COPD) COPD is caused by a variety of factors in clinical syndrome characterized by airway obstruction. In the past that COPD is the general term for chronic bronchitis, emphysema, bronchial asthma and pulmonary heart disease. In recent years, studies suggest that the pathophysiology of various diseases and different stages of bronchial hyperresponsiveness vary, so in 1983 Burrows et al proposed that COPD includes only those who have irreversible airway obstruction of chronic lung disease, chronic bronchitis, Emphysema, bronchial asthma, etc .; that is accompanied by a wide range of persistent airway stenosis, although the bronchodilators (including corticosteroids) treatment can not return to normal who called COPD. Chronic bronchitis are simple bronchitis and obstructive bronchitis two. Both have obvious differences in the pathogenesis and prognosis. The former mainly in the bronchial lesion, rarely developed into airway obstruction. The latter most lesions start in the small airways, can easily lead to airway stenosis. Emphysema is divided into obstructive pulmonary emphysema and non-obstructive emphysema. Obstructive lung