Causes of chronic obstructive pulmonary disease - COPD?
1. In 9 out of 10 COPD patients, bronchial obstruction is caused by smoking cigarettes. The result is chronic bronchitis, which causes bronchoconstriction.
2. Other causes of chronic mucositis and bronchoconstriction are: dust (coal dust, cement dust, flour in mills, etc.); toxic gases in the work and living environment (smog from car exhaust, ozone, sulfur oxide, etc.).
3. The cause of the disease is also often recurrent and rarely treated respiratory infections - especially chronic bronchitis from childhood.
Exacerbation of the course of the disease
In the course of advanced obstructive pulmonary disease there are sudden exacerbations, caused for example by viral infections (cold, flu, bronchitis) and bacterial infections of the airways (sore throat, strep throat, pneumonia). Symptoms of exacerbations include worsening dyspnoea and an increased amount of expectorated secretion, which may be purulent. In patients with impaired lung function due to emphysema during a sudden exacerbation, a respiratory failure may occur. Sometimes the symptoms of this disease mimic asthma and may be confused with it by the sick.
Risk factors for COPD
Despite the statistical causative domination of tobacco smoke, no major disease development is the factor number 1 in causing disease in the majority of compulsive smokers. For unknown reasons, only 1 or 2 in 10 smokers will develop COPD. That is why the list of risk factors remains of great interest. In addition to the aforementioned recurrent respiratory tract infections (and bronchitis) and air pollution, there are mentioned: genetic factors (including alpha-1 antitrypsin deficiency), age, sex, airway hyperresponsiveness, social and living conditions, low birth weight, serious respiratory infections passed in childhood.
The mechanism of bronchoconstriction
Inhaled cigarette smoke, the action of toxic gases or dusts - irritates the bronchi, leading to inflammation of their walls and increased production of mucus bronchial secretions (phlegm). The many years of action of toxic, irritating factors also damage the ciliary bronchi, whose "rowing" movement cleans the respiratory tract of germs and dust. This results in mucus secretion, which thickens and narrows the airways. Chronic bronchitis causes hypersensitivity to external stimuli and weakly reversible bronchospasm.
Fig. 1 Healthy bronchial and diseased ducts - narrowed and not very open
Prolonged discharge of secretions, chronic bronchospasm reduces their light and patency - causing obstruction. This obstructs the airflow through the bronchi and inflow to the lungs. Where did the name of this disease come from?
MEASURING YOUR SICKNESS
The precise determinant of disease severity is the rate of airflow from the lungs during the first second of forced exhalation, using units called FEV1.
What is the spirometry test?
This variable is measured during a special measurement of the exhalation force - using a spirometry test. The spirometer automatically measures both the volume and speed of the air being blown out of the lungs. The most important information obtained from spirometry is the flow value and the volume of air blown out in the first second of forced expiration in brief FEV1. The degree of reduction of the volume of air blown out in the first second of forced expiration (FEV1) against the norm for a healthy person determines the scale of narrowing of the airways.
Development of the disease in the light of pyrometric measurements.
The highest FEV1 value is achieved by a healthy person between 25 and 30 years of age. Healthy people exhale over 70% of their total lung life (VC) during this time.Later, the lungs begin to age, which is manifested by an annual loss of FEV1 of 15-25 mL. However, despite this loss, the healthy human lungs retain sufficient respiratory reserves until late age. In a patient with COPD, FEV1 is reduced by more than 40 mL per year. This causes that between 50 and 60 years old, the patient will lose, irretrievably, over 50% of the lung breathing reserves. A similar process, although of a different intensity, is made in people with asthma. It is measured identically using the same equipment and FEV1 measurement units
Diagnosis of asthma - breath tests
FEV1 measurement and severe disease state
Lowering the FEV1 below 30% between 60 and 70 years is an immediate threat to life caused by complications - respiratory and heart failure.
ed. Edward Ozga-Michalski, MA
Literature:
1. Proceedings in chronic obstructive pulmonary disease in adults in basic and specialist healthcare - Current (2004) British recommendations; ed. prof. dr hab. med. Ewa Niżankowska-Mogilnicka, Department of Pulmonology, II Chair of Internal Diseases, Jagiellonian University Medical College in Krakow; Medycyna Praktyczna 2004/04 (based on Chronic Obstructive Pulmonary Disease National clinical guideline on management of chronic obstructive pulmonary disease in adults and adults. National Collaborating Center for Chronic Conditions. Thorax, 2004; 59 (suppl. I): 1-232 -
2. World strategy for the diagnosis, treatment and prevention of chronic obstructive pulmonary disease; Dr. med. Małgorzata Kołaczkowska Chair and Clinic of Fytziopneumonology, University of Medical Sciences in Poznań (Head: Dr. med. Witold Młynarczyk, Prof. AM); Developed on the basis of the National Heart, Lung, and Blood Institute Reports and WHO as part of the Global Initiative for Chronic Obstructive Lung Disease - Gold), Therapy No. 5 (137), MAY 2003
3. Obstructive pulmonary disease; Interview with dr hab. n. med. Dorota Górecka from the Institute of Tuberculosis and Lung Diseases in Warsaw; Mirosława Błażejowska and Agnieszka Siejca; Medycyna Rodzinna, issue 22 (1/2003)
4. The role of infection in the pathogenesis of chronic obstructive pulmonary disease (COPD) Medycyna Rodzinna - issue 14 (3-4 / 2001)
5. Clinical significance of infections in exacerbation of chronic obstructive pulmonary disease Medycyna Praktyczna 2000/10; she translated the medicine. med. Magdalena Celińska; She consulted dr hab. med. Dorota Górecka.
6. Place of cholinolytics in the treatment of airway obstruction; Dr med. Krzysztof Karwat Chair and Clinic of Internal Diseases, Pneumonology and Allergology of the Medical University in Warsaw; : Therapy No. 2 (133), FEBRUARY 2003
7. New treatment options for inflammatory and obstructive airways diseases - administration of drugs in nebulization; Bow. Maciej Kupczyk, prof. dr hab. med. Piotr Kuna Klinika Pneumonologii i Alergologii AM in Łódź; Therapy NR 4, vol. 1 (119), APRIL 2002
8. Encyclopedias and medical sites
