Chronic non-specific inflammation of trachea, bronchial mucosa and surrounding tissues

Cough and phlegm are the main symptoms

smoking

occupational dust

air pollution

Infectious factors

Degeneration, necrosis and shedding of bronchial epithelial cells

Bronchial tubes at all levels are infiltrated by inflammatory cells (mainly neutrophils/lymphocytes)

Goblet cell and mucus gland hyperplasia/excessive secretion → massive mucus retention

symptom

Signs: Can be heard in the back/double lungs during acute attack→dry/moist rales→can be reduced after coughing

If you have asthma, you may hear widespread wheezing with prolonged respiratory periods.

Key early feature changes

X-ray

Respiratory function test (flow volume curve)

★There are scattered wet and dry rales

Cough, expectoration, wheezing

The onset lasts for 3 months every year → lasts for 2 years/more than 3 years

Bronchial Asthma

eosinophilic bronchitis

bronchiectasis

Control infection (use sensitive antibiotics)

Expectorant and antitussive drugs

Relieve asthma

Persistent respiratory symptoms and airflow limitation

Associated with airway and alveolar abnormalities caused by significant exposure to harmful particles and gases

Pulmonary function tests are of great significance to this disease

The ratio of forced expiratory volume in the first second to forced vital capacity is less than 70%

COPD is closely related to chronic bronchitis and emphysema

COPD can lead to chronic respiratory failure and chronic cor pulmonale

inflammatory mechanism

Protease-Antiprotease Imbalance Mechanism

oxidative emergency mechanism

Mainly pathological changes of chronic bronchitis and emphysema

According to the cumulative lung lobule section

Continuous airflow limitation leads to pulmonary ventilation dysfunction (main pathophysiological characteristics) → As the disease progresses → Lung tissue elasticity decreases → Alveolar retraction disorder

Emphysema worsens → a large number of capillaries around the alveoli are squeezed → capillaries decrease/blood volume decreases → dead space increases

symptom

physical signs

Pulmonary function test (gold standard)

Chest X-ray

other

Prognosis → The disease is irreversible

The most important drug for COPD

Drugs for acute exacerbations

spontaneous pneumothorax

chronic pulmonary heart disease

★Cor pulmonale Pneumothorax

COPD acute exacerbation and pulmonary encephalopathy

Hyperinflation of the lungs

airway hypersensitivity

There is reversible airway obstruction

interstitial pneumonia

Small airway disease

Large airway disease

followed by ventilatory dysfunction

Massive loss of alveoli and capillaries → obstruction of ventilation