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您现在的位置: 医学全在线 > 医学英语 > 临床英语 > 临床英语 > 正文:COPD (Chronic Obstructive Pulmonary Disease)—慢阻肺
    

慢阻肺-COPD(Chronic Obstructive Pulmonary Disease)

What is COPD?

COPD (Chronic Obstructive Pulmonary Disease) is a general term which includes the conditions chronic bronchitis and emphysema.

  • Chronic means persistent.
  • Bronchitis is inflammation of the bronchi (the airways of the lungs).
  • Emphysema is damage to the smaller airways and airsacs (alveoli) of the lungs.
  • Pulmonary means 'affecting the lungs'.

Chronic bronchitis or emphysema can cause obstruction (narrowing) of the airways. Chronic bronchitis and emphysema commonly occur together. The term COPD is used to describe airways which are narrowed due to chronic bronchitis, emphysema, or both.

How common is COPD?

COPD is common in the UK. It mainly affects people over the age of 40. It accounts for more time off work than any other illness. A flare-up (exacerbation) of COPD is one of the commonest reasons for admission to hospital.

What causes COPD?

Smoking is the cause in the vast majority of cases. There is no doubt about this. The lining of the airways becomes inflamed and damaged by smoking. About 3 in 20 one-pack-per-day smokers, and 1 in 4 two-pack-per-day smokers develop COPD if they continue to smoke. Air pollution and polluted work conditions may play a part,or make the disease worse. However, people who have never smoked rarely develop COPD.

What are the symptoms of COPD?

  • Cough is usually the first symptom to develop. It is productive with phlegm (sputum). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. It is when the breathlessness begins that people often become concerned.
  • Breathlessness ('short of breath') and wheeze may occur only when you exert yourself at first (for example, when you climb stairs). These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.
  • Sputum. The damaged airways make a lot more mucus than normal. This forms sputum (phlegm). You tend to cough up a lot of sputum each day. 医学线网站www.med126.com
  • Chest infections are more common if you have COPD. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection. Sputum usually turns yellow or green during a chest infection.

What's the difference between COPD and asthma?

Asthma and COPD cause similar symptoms. However, they are different diseases. Very briefly:

  • In COPD there is permanent damage to the airways. The narrowed airways are 'fixed', and so symptoms are chronic (persistent). Treatment to 'open up the airways' is limited.
  • In asthma there is inflammation in the airways which causes muscles in the airways to constrict. This causes the airways to narrow. The symptoms tend to 'come and go', and vary in severity from time to time. Treatment to reduce inflammation and to 'open up the airways' usually works well.
Both asthma and COPD are common, and some people have both conditions.

Do I need any tests?

A test called spirometry is often done to confirm the diagnosis. This test measures how much air that you blow into a machine. A value is calculated of the amount of air you can blow out in one second divided by the total amount of air you blow out. A low value indicates that you have narrowed airways. A low value combined with the typical symptoms of COPD usually confirms the diagnosis.

What is the progression and outlook of COPD?

Symptoms usually begin in people aged over 40 who have smoked for 20 years or more. A 'smokers cough' tends to develop at first. Once symptoms start, if you continue to smoke, there is usually a gradual decline over several years. You tend to become more and more breathless. Chest infections tend to become more frequent as time goes by. A flare-up of of symptoms (exacerbation) occurs from time to time, typically during a chest infection.

As the disease becomes more severe, not enough oxygen may get into the lungs through the narrowed airways. As a result, the amount of oxygen that gets into the bloodstream is less than normal. This can cause heart failure as the heart needs a good oxygen supply.

At least 25,000 people die each year in the UK from the end stages of COPD. Many of these people have several years of ill health and poor quality of life before they die. Chronic ill health and death due to COPD is preventable in most cases (see below).

How can the course of the COPD be altered?

Stop smoking. This cannot be stressed enough. If you stop smoking at an early stage of the disease, it will make a huge difference. Any damage already done to your airways cannot be reversed, but stopping smoking prevents the disease from getting much worse. It is never too late to stop at any stage of the disease. Even if you have fairly advanced COPD, you are likely to benefit and prevent further progression of the disease.

Cough may become worse for a while when you give up smoking. This often happens as the lining of the airways 'come back to life'. Resist the temptation to start smoking again to ease the cough. An increase in cough after you stop smoking usually settles in a few weeks.

See a practice nurse or doctor if you have difficulty in stopping smoking. Help is available. For example, counselling, nicotine replacement therapy (nicotine gum etc), and another medicine to help with stopping smoking may help. Another leaflet discusses giving up smoking in more detail.

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