阻塞性与限制性肺部疾病
Obstructive lung diseases feature blocked airways while restrictive lung diseases feature an inability to expand or loss of elastic recoil of肺。常见的阻塞性肺部疾病是哮喘,支气管炎,支气管扩张和慢性阻塞性肺疾病(COPD)。常见的限制性肺部疾病是囊性纤维化和其他导致肺疤痕的原因。囊性纤维化与阻塞性肺部疾病具有某些特征,但根据病理生理学。Though both obstructive and restrictive lung diseases share some symptoms, signs, diagnosis, and treatment methods, there are slight variations too. This article will talk about those in detail.
What are Obstructive Lung Diseases?
常见的阻塞性肺部疾病是哮喘,支气管炎,支气管炎和COPD。
哮喘影响5-8%的人口。大多数哮喘儿童会从中成长或像成年人一样遭受少得多的痛苦。它的特征是呼吸困难,咳嗽和由可逆气道阻塞引起的喘息发作。三个因素导致气道狭窄:支气管肌肉收缩是由多种刺激,粘膜肿胀/炎症引起的,由肥大细胞引起的和嗜碱性粒细胞脱粒,从而释放炎症介质,并增加粘液生产。冷空气,运动,情绪,过敏原,感染和药物触发情节。气道直径全天变化,在早晨和晚上最小。因此,大多数攻击发生在一天中的这个时候。酸回流与哮喘有关。通常进行肺活量测定法,过敏原和胸部X射线的皮肤刺测试。支气管扩张剂和类固醇作为吸入剂,片剂或紧急情况下,作为治疗的静脉注释。
支气管炎is inflammation of larger airways. It is most commonly viral or bacterial. Patient presents with cough, shortness of breath, sputum production, and sometime fever. There is airway obstruction due to mucus production and bronchial muscle contraction. Bronchitis is treated with steam inhalation, bronchodilators and抗生素。
支气管扩张是由于支气管和支气管的慢性感染导致永久性扩张这些气道。heamophilus流感,链球菌肺炎,葡萄球菌金黄色葡萄酒和Pseudomonas aeruginosa are the usual culprits. Young syndrome, primary ciliary dyskinesia, cystic fibrosis, Kartergener syndrome, bronchial obstruction due to tumors, and foreign bodies and allergic broncho-pulmonary aspergillosis can lead to bronchiectasis. Bronchiectasis features persistent cough, sputum production, shortness of breath, finger clubbing. It is treated with postural drainage of sputum, antibiotics, bronchodilators and steroids.
慢性阻塞性肺疾病(COPD)由两个密切相关的临床实体组成;慢性支气管炎(长期以咳嗽和痰液为特征的大型气道的长期发炎,大部分时间是连续两年的3个月)和气肿(loss of elastic recoil of lung and histologically, enlargement of airway smaller than terminal bronchioles and destruction of walls ofalveoli)。Patients may have either asthma or COPD but not both. If the patient is above 35 years of age, has a history of smoking, long standing production of sputum, cough, shortness of breath without clear variations throughout the day, COPD is likely. NICE (National Institute for Healthcare Excellence) recommends the name COPD. Smoking is the main risk factor for COPD. The tendency to develop COPD rises with the number of cigarettes smoked and all lifelong smokers get COPD.
在金矿,煤矿,纺织厂工作的人,由于化学物质和灰尘暴露会导致气道反应状态升高,因此也可能会获得COPD。与香烟相似,这些分子增加了气道的分泌物,并导致气道收缩。尽管COPD是可以管理的,但无法治愈。急性加重在紧急单位接受支气管扩张剂,类固醇和抗生素治疗。
什么是限制性肺部疾病?
常见的限制性肺部疾病是囊性纤维化和其他导致肺疤痕的原因。
囊性纤维化是最普遍的威胁生命之一常染色体隐性条件影响高加索人。它是由突变在囊性纤维化跨膜电导基因中。这导致氯化物分泌有缺陷和跨气道吸收增加的结合上皮。The changes in the composition of airway surface liquid predispose the lung to infections and bronchiectasis. Patients present with cough, wheeze, failure to thrive, pancreatic insufficiency, intestinal obstruction,肝硬化和骨质疏松症。胸部物理疗法,胰酶替代,脂溶性维生素替代和降低血糖是囊性纤维化的重要治疗方法。囊性纤维化患者的平均存活率现在已超过30年。
阻塞性肺部疾病和限制性肺部疾病有什么区别?
•气道blockag阻塞性肺部疾病特征e while restrictive diseases feature a failure of lung expansion.
•在阻塞性肺部疾病中,粘液形成增加,而限制性疾病没有。
•限制性疾病是由于肺部疤痕引起的,而阻塞性疾病没有疤痕。
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