I. What is chronic obstructive pulmonary disease (COPD)?
Chronic obstructive pulmonary disease (COPD) is a disease characterized by airflow limitation, including chronic bronchitis and/or emphysema. This airflow limitation usually develops progressively, is not fully reversible, and is mostly associated with an abnormal inflammatory response of the lungs to harmful particulate matter or noxious gases.
Second, what are the main causes of chronic obstructive pulmonary disease?
1, smoking: smoking can damage the bronchial epithelial cilia, affect cilia movement, weaken the alveolar phagocyte phagocytosis, sterilization function, reduce local resistance, can also induce bronchospasm and increase airway resistance.
2, atmospheric pollution: chlorine, nitric oxide, nitrogen dioxide and other chemical gases or smoke, silica, coal dust, dust and some crop dust, etc. also have a stimulating and toxic effect on the bronchi, inducing slow obstructive pulmonary.
3, infection: rhinovirus, adenovirus, parainfluenza virus, influenza B virus and other viruses, as well as pathogenic microorganisms such as Streptococcus pneumoniae and H. influenzae is another important factor in the onset and exacerbation of chronic bronchitis.
4, allergic factors: allergic factors have a relationship with the onset of chronic bronchitis, especially wheezing chronic bronchitis.
5, other: climate change, especially cold air can cause increased mucus secretion, weakening bronchial cilia movement. Older people and hyperalgesia, weakened laryngeal reflex, poor respiratory defense, vitamin A, vitamin C and other nutrient deficiencies are also associated with increased incidence of chronic bronchitis.
Third, how to detect slow-onset lung?
It is important to raise the vigilance to the clinical manifestations of chronic obstructive pulmonary disease and the corresponding examination. Patients with chronic obstructive pulmonary disease mostly have a history of obvious exposure to risk factors, and have airflow obstruction that cannot be completely reversed, manifesting as chronic cough and coughing, but may not be accompanied by clinical symptoms until the late stage of shortness of breath and dyspnea after activity. Some patients complain of an acute respiratory tract infection, but it is possible that the patient had an unnoticed chronic cough and sputum until the respiratory tract infection further deteriorated the already diminished lung function and manifested shortness of breath and dyspnea. Some patients with emphysema as the main lesion often complain of weakness, fatigue, and weight loss at the first visit, and it is sometimes not easy to think that this is a clinical manifestation of slow-onset lung without careful questioning.
In order to improve the early diagnosis of slow-onset lung, pulmonary function tests should be performed in all patients who suffer from cough with excessive sputum and have a history of risk factor exposure. If FEVl/FVC is <70% and FEV1 is <80% of the expected value after bronchodilator application, it is certain that the patient has airflow obstruction that cannot be completely reversed and should be considered for the diagnosis of slow-onset lung. The diagnosis of slow-onset lung should be considered. Electrocardiogram can detect arrhythmia and right heart hypertrophy. Blood gas analysis can help determine the presence of respiratory failure and guide treatment.
What are the dangers of slow-onset lung?
Chronic obstructive pulmonary disease can lead to histopathological destruction of airways and lungs and corresponding pathophysiological changes, including mucus hypersecretion, cilia dysfunction, airflow limitation, lung hyperinflation, abnormal gas exchange, pulmonary hypertension and pulmonary heart disease. The development of pulmonary hypertension in the late stages of chronic obstructive pulmonary disease is an important cardiovascular complication that is associated with the development of pulmonary heart disease and suggests a poor prognosis. The progression of chronic obstructive pulmonary disease produces hypoxemia, followed by hypercapnia and respiratory failure, leading to death. The morbidity and mortality of COPD are high and it is currently the fourth cause of death in the world and is estimated to be the third cause of death in 2020. Therefore, it can be said that chronic obstructive pulmonary disease has become an important global health problem.
V. How to prevent slow-onset lung?
Stopping smoking, reducing occupational dust and chemical inhalation, and reducing indoor and outdoor air pollution are important measures to prevent the occurrence of chronic obstructive pulmonary disease. In particular, stopping smoking is currently the most effective and cost-effective measure to reduce the risk factors for slow-onset lung and to stop its progressive development. Several effective smoking cessation medications are now available for application. In addition, improving the living environment, increasing resistance and avoiding pathogenic microbial infections can also help to prevent COPD. There is also a trial of vitamin A and antioxidants for the treatment of slow-onset lung in progress.
What should I do if I have slow-onset lung?
1.Know yourself and your enemy: You should receive health education, master the basic knowledge of slow obstructive pulmonary disease, understand the extent of the disease and the corresponding treatment principles, and cooperate closely with the doctor’s treatment.
2.Avoid triggering: Quit smoking and avoid environmental pollution of large and small size are not only important measures to prevent the occurrence of slow-onset lung, but also important means to slow down the progress of the disease. Once the diagnosis is clear, it should be implemented immediately.
3.Close monitoring: Changes in disease and response to treatment should be closely monitored. Among the clinical symptoms, cough, sputum and wheezing have important reference value for determining the change of disease. Sudden aggravation of cough, sputum and wheezing often indicates that the condition suddenly changes from stable to acute exacerbation and requires enhanced treatment. Increased sputum volume and yellow color often indicate pathogenic microbial infection, and sputum specimens should be taken immediately to isolate and identify the pathogenic microorganisms and give corresponding treatment.
Laboratory tests, such as pulmonary function and blood gas analysis, are important for determining the severity of the disease and guiding the treatment; arterial blood gas analysis should be performed when FEV1 is <40% of the expected value or when clinical symptoms suggest respiratory failure or right heart failure. Once respiratory failure or right heart failure is detected, immediate admission to hospital is required.
4.Comprehensive treatment: Take corresponding comprehensive treatment measures for patients in the stable stage and acute exacerbation stage respectively.
The comprehensive treatment in the stable stage is mainly for health education, improving immune function, improving symptoms and reducing complications. To improve symptoms, bronchodilators (especially anticholinergic drugs and/or β2 agonists) and/or regular inhaled glucocorticoid therapy can be applied, but glucocorticoid therapy is only applicable to patients with symptomatic and effective chronic obstructive pulmonary disease and confirmed by pulmonary function tests, and long-term application of systemic hormone therapy should be avoided. Rehabilitation exercises help to improve overall health quality, including immune function. Long-term application of oxygen therapy may also be considered for patients with hypoxemia.
The treatment of patients with acute exacerbation of chronic obstructive pulmonary disease is mainly to remove the causative factors, rapidly correct the physiological abnormalities, and strive for an early return to the remission state. The most important causative factors for acute exacerbation in patients with chronic obstructive pulmonary disease are tracheal and bronchial infections and air pollution. For those with increased sputum and pus sputum, accompanied by fever, antibiotic therapy should be given. Phlegmolytic drugs, bronchodilators, theophylline, glucocorticoids (oral preparations are preferred, but long-term application should be avoided) and controlled oxygen therapy are mostly effective in improving symptoms and treating acute exacerbations of slow obstructive pulmonary disease. For those with respiratory failure, non-invasive mechanical ventilation can be preferred, and invasive mechanical ventilation can be considered when it is ineffective.