Chronic obstructive pulmonary disease is a lung disease characterized by airflow limitation that is not completely reversible and progresses progressively. It occurs in association with an abnormal inflammatory response of the lungs to harmful gases or harmful particles. As the disease recurs and worsens acutely, it leads to a gradual decline in lung function and the appearance of shortness of breath even during daily activities and even at rest.
Main etiology
It is generally believed that factors associated with the development of both COPD and obstructive emphysema may be involved in the development of chronic obstructive pulmonary disease. The risk factors that have been identified can be broadly classified into two categories: exogenous (i.e., environmental) and endogenous (i.e., individual predisposing factors).
Exogenous factors include smoking, dust and chemical inhalation, air pollution, respiratory infections, etc. People with lower socioeconomic status are also susceptible and may be associated with indoor and outdoor air pollution, crowded living rooms, and poorer nutrition.
Endogenous causes include genetic factors, increased airway reactivity, etc., while the disease can develop during pregnancy, neonatal period, infancy, or childhood due to various causes of poor lung development or growth in individuals, and then develop.
Predisposing factors
Smoking
is the most important environmental pathogenic factor.
Infectious factors
Viral, mycoplasma and bacterial infections are an important cause of acute exacerbations in patients with COPD.
Epidemiology
Chronic obstructive pulmonary disease (COPD) is a common and frequent disease of the respiratory system, with high prevalence and mortality rates. 1992 surveyed 102,230 rural adults in the northern and central regions of China, and the prevalence of COPD was 3%. 2018 newly released epidemiological survey results of COPD in China showed that the prevalence of COPD accounted for 13.7% of people over 40 years of age. 13.7%. In China, chronic obstructive pulmonary disease is the most common cause of chronic respiratory failure and chronic pulmonary heart disease, accounting for about 80% of all cases. It seriously affects patients' workforce and quality of life due to progressive decline in lung function. Chronic obstructive pulmonary disease poses a huge social and economic burden, and according to a study published by the World Bank/WHO, it is expected to account for the fifth largest economic burden of disease in the world by 2020.
Prevalent populations
Chronic obstructive pulmonary disease (COPD) is more prevalent in the elderly, especially those with underlying diseases such as emphysema and chronic obstructive pulmonary disease (COPD).
Patients who are exposed to air pollution for a long time, such as chemical fumes or dust, are also prone to the disease.
Patients who inhale secondhand smoke for a long time are more likely to develop the disease than healthy patients.
Symptoms
Chronic obstructive pulmonary disease has a slow onset and a long duration. Chronic cough, coughing, shortness of breath, chest tightness, etc. may appear as the disease progresses.
Typical symptoms
Chronic cough
The cough is often obvious in the morning, with paroxysmal cough or sputum at night, and may last for life as the disease progresses.
Coughing sputum
Generally white mucus or plasma foamy sputum, occasionally with blood, more sputum in the early morning. The sputum volume increases during the acute attack, and there may be purulent sputum.
Shortness of breath or dyspnea
Shortness of breath is a hallmark symptom of COPD. It appears early during more strenuous activity and gradually worsens so that shortness of breath is felt even during daily activities and even at rest.
Wheezing and chest tightness
Wheezing occurs in some patients, especially in severe cases or during acute exacerbations.
Other symptoms
Advanced patients have weight loss and loss of appetite.
Complications
Chronic respiratory failure
Often occurs during acute exacerbation of COPD, with marked exacerbation of its symptoms, development of hypoxemia and/or hypercarbia, and clinical manifestations of hypoxia and carbon dioxide retention.
Spontaneous pneumothorax
If there is a sudden aggravation of dyspnea with marked cyanosis, a drum sound on percussion of the affected lung, and diminished or absent breath sounds on auscultation, the complication of spontaneous pneumothorax should be considered, and the diagnosis can be confirmed by X-ray examination.
Chronic pulmonary heart disease
Chronic obstructive pulmonary disease causes pulmonary artery constriction and vascular remodeling due to the reduction of pulmonary vascular bed and hypoxia, resulting in pulmonary hypertension, right ventricular hypertrophy and enlargement, and eventually right heart insufficiency.
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