COPD第四讲(大学课件)2013.10.15

Chronicobstructivepulmonarydisease/copd/HTML/copd_35551.htmCOPD是一种具有气流受限特征的肺部疾病，气流受限不完全可逆，呈进行性发展。与慢性支气管炎（chronicbronchitis）、肺气肿（emphysema）密切相关。

ChronicobstructivepulmonarydiseaseasthmaCOPDReversibilityofairwayobstructionFULLNONEasthmaemphysemaChronicbronchitisPREVALENCEofMORTALITY

In2000,theWHOestimated2.74millionCOPDdeathsworldwide.In1990,COPDwasranked12th

leadingcauseofdeath.Itisexpectedtobethethirdleadingcauseofdeathby2020.CauseDeathsCHD（冠心病）724,269Cancer534,947CVA（脑血管意外）158,060COPD114,318Accidents94,828Diabetes64,574(2000)*TheIndianJChestDis&AlliedSciences2009;43:139-474PREVALENCEofMORBIDITYCigarettesmokingistheprimarycause.YearConsultations19806.1million19857.4million199010.1million199511.8million200013.9million2025↑↑1.6billion?

4000chemicals(morethan60

carcinogens)areinhaledincigarettesmoke[kɑ:'sɪnədʒən]致癌物6RiskFactorsforCOPDNutritionInfectionsSocio-economicstatusAgingPopulationsGenes(alpha1-anti-trypsin↓)TYPESOFCOPDDoyouknow?TheKingofPopsufferedfromAlpha1-anti-trypsindeficiencyClinicalManifestationsDiagnosisisconsideredwithCoughSputumproduction咳痰，排痰DyspneaClinicalManifestationsIntermittentCoughwithexpectorationProgressiveDyspnea

Describedbythepatientasan“increasedefforttobreathe,”“heaviness,”“airhunger,”or“gasping.”

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vi.喘气，喘息；渴望

ClinicalManifestationschestbreathingUseofaccessorymusclessuchasthoseintheneckandintercostalmusclesDecreasedabdominalbreathing–flatteneddiaphragmfromoverdistendedlungs.Purselipbreathing