Chronic obstructive pulmonary disease - a concept relatively recently (in the early 1990s), which became part of the Russian practice of medicine.In order to overcome ambiguities in the definition of and approaches to the diagnosis and treatment of COPD were established national and international standards on this issue.
first COPD is a collective concept, which includes virtually all chronic diseases of bronchopulmonary system in the final stage of its development (chronic bronchitis, bronchial asthma, emphysema, bronchiolitis obliterans, cystic fibrosis, bronchiectasis).COPD is viewed as the outcome of these diseases, when it erased the distinctive features of each disease and the fore symptoms of respiratory failure and irreversible airway obstruction.Currently, however, chronic obstructive pulmonary disease is an independent nosological form, has its own specific stage of development with characteristic clinical m
Chronic obstructive pulmonary disease is a chronic inflammatory disease with a primary lesion of the distal bronchial tree and lung parenchyma, characterized by the development of irreversible (or not fully reversible) airflow obstruction and leads to the formation of pulmonary emphysema.
disease develops in predisposed individuals during long-term adverse effects of inhaler environmental factors (smoke, dust, gases).Most often this is the influence of tobacco smoking.The constant irritation of the bronchial mucosa by tobacco smoke leads to a restructuring of the secretory system (there is overgrowth of mucus glands, increased mucus production, increased viscosity of bronchial secretions) and damage to the ciliated epithelium of the mucous membrane (due to impaired transport of bronchial secretions towards the throat, suffering purifying and protective function of bronchi).The result is a chronic inflammation of the bronchi and alveoli, which over time leads to irreversible changes: growing smooth muscle in the walls of the bronchi, developing fibrosis (connective tissue replacement) airway and peribronchial tissue, alveoli are destroyed.
Establishing a diagnosis of COPD is based on the identification of the main clinical symptoms: cough, sputum, shortness of breath.At the same time be sure to take into account the presence of risk factors and to exclude pulmonary disease with similar symptoms.
To confirm the diagnosis must be instrumental examination of the patient.The leading role in the diagnosis of COPD and objective assessment of the severity of the disease is the study of respiratory function (ERF).Spirometry and spirography are the most common methods of investigation of respiratory function, and the most informative indicator of ERF to assess the severity of obstruction, severity and progression of COPD is a change in forced expiratory volume in the first second (FEV1), which is constantly reduced.It is important that samples from COPD bronchodilator FEV1 do not give a gain of more than 10 - 15%, which indicates the irreversible nature of bronchial obstruction.
Intrigue COPD is a slow but steady progression: clinical symptomatology appears only in the advanced stage of the disease.
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