复旦大学临床医学专业：《内科学》课程教学资源（PPT课件讲稿）慢支肺气肿（蔡映云）

Chapter three Chronic obstructive Pulmonary Diseases (COPD) Chronic bronchitis Obstructive Pulmonary emphysema

Chapter three • Chronic Obstructive Pulmonary Diseases (COPD) • Chronic Bronchitis • Obstructive Pulmonary Emphysema

Definition of copd Including chronic bronchitis and pulmonary emphysema Chronic airflow limitation progressing slowly Partial reversibility Abnormal inflammatory response of the lungs to noxious particles or gases

Definition of COPD • Including chronic bronchitis and pulmonary emphysema • Chronic airflow limitation • progressing slowly • Partial reversibility • Abnormal inflammatory response of the lungs to noxious particles or gases

Classification of copd by severity Stage o( at risk Chronic cough and sputum production Contact with harmful factors FEV1/FVC>70% Stage I( mild) FEV1/FVC <70% FEVI 8 80 predicted usually, but not always, chronic cough and

Classification of COPD by Severity • Stage 0 ( at risk) – Chronic cough and sputum production – Contact with harmful factors – FEV1/FVC > 70% • Stage I( mild) – FEV1/FVC < 70% – FEV1  80 % predicted – usually, but not always, chronic cough and sputum production

Classification of CoPd by Severity Stage l( moderate) ll:FⅥ1/F∨C<70% 50%8 FEV1 < 80% predicted IR: FEV1/FVC <70% 30%8 FEV1 < 50% predicted With or without symptom

Classification of COPD by Severity • Stage II( moderate) – IIA : FEV1/FVC < 70% 50% FEV1 < 80% predicted – IIB : FEV1/FVC < 70% 30% FEV1 < 50% predicted With or without symptom

Classification of CoPd by Severity Stage ll( severe FEVI/FVC<70% FV1δ30% predicted or with respiratory failure or cardiac failure

Classification of COPD by Severity • Stage III( Severe) – FEV1/FVC < 70% – FEV1 30 % predicted or with respiratory failure or cardiac failure

Chronic bronchitis ( Definition Chronic nonspecific inflammation in mucosa and its peripheral tissues of trachia and bronchus

一 .Chronic bronchitis • (一) Definition Chronic nonspecific inflammation in mucosa and its peripheral tissues of trachia and bronchus

(二) Etiology 1. Smoking Epidemical information Pathological examination Effects of giving up smoking Animal experiment

（二）Etiology • 1.Smoking – Epidemical information – Pathological examination – Effects of giving up smoking – Animal experiment

(二) Etiology 2. Airway infection Virus Bacteria Mycoplasma

（二）Etiology • 2.Airway infection – Virus – Bacteria – Mychoplasma

(二) Etiology 3. physical and chemical factors Air pollution Occupational contamination Indoor and outdoor fumes 4. Climate Cold weather Variation of atmospheric temperature

（二）Etiology • 3.physical and chemical factors – Air pollution – Occupational contamination – Indoor and outdoor fumes • 4.Climate – Cold weather – Variation of atmospheric temperature

(二) Etiology 5. Atopy 6.Immunological and defensive disturbance 7.Imbalance between sympathetic and parasympathetic nerves systems 8. Deficiency of Vit C anda

（二）Etiology • 5.Atopy • 6.Immunological and defensive disturbance • 7.Imbalance between sympathetic and parasympathetic nerves systems • 8.Deficiency of Vit C and A