Chronic lung disease. Diagnosis of COPD: causes, symptoms, diagnosis and treatment. chronic obstructive pulmonary disease. Signs and symptoms of COPD

The disease in question is an inflammatory disease that affects the distal parts of the lower respiratory tract, and which is chronic. Against the background of this pathology, the lung tissue and blood vessels are modified, and the patency of the bronchi is significantly impaired.

The main symptom of COPD is the presence of obstructive syndrome, in which patients can be diagnosed with bronchial inflammation, bronchial asthma, secondary emphysema, etc.

What is COPD - the causes and mechanism of chronic obstructive pulmonary disease

According to the World Health Organization, the disease in question tops the 4th place in the list of causes of death.

Video: Chronic obstructive pulmonary disease

This pathology is formed under the influence of not one, but a number of factors, which include:

• Tobacco smoking. This bad habit is the most common cause of COPD. An interesting fact is that among village residents, chronic obstructive pulmonary disease occurs in more severe forms than among urban residents. One of the reasons for this phenomenon is the lack of lung screening among smokers after 40 years of age in Russian villages.
• Inhalation of harmful microparticles at work. In particular, this applies to cadmium and silicon, which are released into the air during the processing of metal structures, as well as due to fuel combustion. Miners, railway workers, construction workers who often come into contact with cement-containing mixtures, and agricultural workers who process cotton and grain crops are at increased risk.
• Unfavorable environmental conditions.
• Frequent respiratory infections in preschool and school periods.
• Associated ailments of the respiratory system: bronchial asthma, tuberculosis, etc.
• Prematurity of babies. At birth, their lungs do not expand completely. This affects their functioning and can cause serious exacerbations in the future.
• Congenital protein deficiency, which is produced in the liver and is designed to protect lung tissue from the destructive effects of elastase.

Against the background of genetic aspects, as well as unfavorable natural factors, inflammatory phenomena occur in the inner lining of the bronchi, which become chronic.

This pathological condition leads to a modification of the bronchial mucus: it becomes larger, its consistency changes. This causes disruptions in the patency of the bronchi, and provokes the development degenerative processes in the pulmonary alveoli. The overall picture may be aggravated by the addition of bacterial exacerbations, which provokes re-infection of the lungs.

In addition, the disease in question can cause disturbances in the functioning of the heart, which is reflected in the quality of blood supply to the respiratory system. This condition in chronic forms is the cause of death in 30% of patients diagnosed with chronic obstructive pulmonary disease.

Signs and symptoms of chronic obstructive pulmonary disease - how to notice in time?

At the initial stages of development, the pathology in question is often doesn't show itself at all. The typical symptomatic picture appears in moderate stages.

Video: What is COPD and how to detect it in time?

This pulmonary disease has two typical symptoms:

1. Cough. It makes itself felt most often after waking up. During the coughing process, a certain amount of sputum is released, which is viscous in consistency. When bacterial agents are involved in the pathological process, the sputum becomes purulent and profuse. Patients often associate this phenomenon with smoking or working conditions; therefore, they do not often go to a medical institution for advice.
2. Shortness of breath. At the beginning of the development of the disease, a similar symptom appears when walking quickly or climbing a hill. As COPD develops, a person becomes out of breath even when walking a hundred meters. This pathological condition causes the patient to move more slowly than healthy people. In some cases, patients complain of shortness of breath while undressing/dressing.

According to its clinical manifestations, this pulmonary pathology is divided into 2 types:

• Bronchitic. The symptomatic picture here is clearly expressed. This is associated with purulent-inflammatory phenomena in the bronchi, which is manifested by a strong cough and copious mucous discharge from the bronchi. The patient's body temperature rises, he constantly complains of fatigue and lack of appetite. The skin acquires a bluish tint.
• Emphysematous. It is characterized by a more favorable course - patients with this type of COPD often live up to 50 years of age. A typical symptom of the emphysematous type of disease is difficulty breathing. The sternum becomes barrel-shaped and the skin becomes pinkish-gray.

Chronic obstructive pulmonary disease affects not only the functioning of the respiratory system; almost the entire body suffers.

The most common violations include:

1. Degenerative phenomena in the walls of blood vessels, which provokes the formation of atherosclerotic plaques - and increases the risk of blood clots.
2. Errors in heart function. Patients with COPD are often diagnosed with a systematic increase in blood pressure and coronary heart disease. The possibility of acute myocardial infarction cannot be excluded.
3. Atrophic processes in muscles that are involved in respiratory function.
4. Serious impairment of kidney function.
5. Mental disorders, the nature of which is determined by the stage of development of COPD. Such disorders may include sleep apnea, poor sleep, difficulty remembering events, and difficulty thinking. In addition, patients often feel sad and anxious and often become depressed.
6. Reduced defense reactions of the body.

COPD stages - classification of chronic obstructive pulmonary disease

According to the international medical classification, the disease in question goes through 4 stages.

Video: COPD. Why is it not easy for the lungs?

At the same time, when dividing the disease into specific forms, two main indicators are taken into account:

• Forced expiratory volume - FEV .
• Forced vital capacity - FVC – after taking medications that relieve symptoms of acute bronchial asthma. Normally, FVC should not exceed 70%.

Let us consider the main stages of development of this pulmonary pathology in more detail:

1. Zero stage. Standard symptoms at this stage are a regular cough with slight sputum production. At the same time, everyone’s lungs function without disturbance. This pathological condition does not always develop into COPD, but there is still a risk.
2. First (mild) stage. The cough becomes chronic and sputum is produced regularly. Diagnostic measures can reveal minor obstructive errors.
3. Second (moderate) stage. Obstructive disorders intensify. The symptomatic picture becomes more pronounced with physical activity. There are difficulties with breathing.
4. Third (severe) stage. The air flow during exhalation is limited in volume. Exacerbations become a regular occurrence.
5. Fourth (extremely severe) stage. There is a serious risk to the patient's life. Typical complications at this stage of COPD development are respiratory failure and serious disruptions in the functioning of the heart, which affect the quality of blood circulation.

2013-03-04 08:51:28

Sergey asks:

Hello, dear doctors! I have been diagnosed with COPD-2nd degree, bronchiectasis - bronchiectasis was found in the lower lobe of the left lung! The last prescription was: desonvalization in the area of ​​the bronchi and lungs, UHF in the same area, Ultrasound waves in the same area, nasal tube and nasopharynx! For medicinal purposes: Berodual 2 inhalations / 2 times a day, Symbicort Turbuhaller 1 inhalation / 2 times a day, Levoflxacin 1 tab (500 mg) per day - for now they said to take it for 14 days, and then for a follow-up examination! I can tell you, that purulent sputum has decreased to 10-25 grams, my health has improved a little! I would like to note that I have been sick for a little over a year, but this is the first time that a physiotherapy room has been prescribed!
Recommendations: sanatorium and resort treatment on the Crimean coast, active swimming, exercises for postural drainage! A therapeutic bronchoscope is also recommended to consolidate remission.
Currently, a complete change in lifestyle: after I changed my sedentary job to a more active one, the cough became less of a concern, sputum does not come out all the time, but only in small quantities in the morning. Also, after taking Levoflox, the purulent sputum decreased.
Questions: 1-how long do they live with such diagnoses? 2-how adequate can this therapy and recommendations be considered? 3-I noticed that after taking Levoflox (almost at the end of the 14-day intake), severe heartburn, loss of appetite and pain in the epigastric areas! Can these symptoms be associated with taking this drug?
I visit a local therapist once a month and a regional pulmonologist once every three months! They are similar in many ways, but the local therapist insists on mixed therapy, namely (medicines and a physiotherapy room) - he says that the effectiveness of treatment increases significantly, is this true?
And in revenge for everyone who is being treated on their own, I can add from myself (People, don’t self-medicate, otherwise it will be like mine, it seems that it was possible to cure, but I thought that I could handle it myself, I didn’t succeed, now I’m suffering) All lovers of delicious food and colored pills, advice from grandmothers and fashion magazines, simple advice, if you feel ill, put your life in the hands of qualified specialists, otherwise your life can turn into hell! Thank you to the doctors for future answers, and to readers like me, good health, prudence, and in this case, a good specialist! With respect and gratitude, Sergey!

Answers Gordeev Nikolay Pavlovich:

Hello, Sergey.
First, with diagnoses of this type, with adequate therapy, as in your case, you can live quite a long time with a satisfactory quality of life.
Secondly, such phenomena as heartburn, loss of appetite, etc. dyspepsia occurs in approximately 1/5 of patients taking levoflox, can be corrected by taking medications for the treatment of gastritis and peptic ulcers (your doctor will most likely prescribe them) and is reversible after completing the course.
Third, your therapist is certainly right about combination therapy. Its effectiveness is always higher than with chemotherapy alone. The fact that you are regularly seen by two specialists is only to your benefit, because... there is a clinical effect from therapy. Good health to you.

2011-05-16 12:40:30

Anna asks:

Good afternoon. I have this story: As a child, at 2 weeks of age, I suffered from pneumonia. All my life I have been constantly coughing, sometimes with streaks of blood. I was in bed with pneumonia several times. Doctors diagnosed chronic bronchitis. At the age of 26 she became pregnant. Shortness of breath, severe toxicosis, and weight loss appeared. With the first kicks of the child, profuse hemoptysis appeared. Fluorography showed pulmonary dissemination. With suspicion of tuberculosis in serious condition, he was taken to the tuberculosis dispensary in the diagnostic department. The child could not be saved. They took cultures 3 times, it showed nothing. Bronchoscopy gave positive results. Several liters of purulent sputum were pumped out. They began to give anti-tuberculosis drugs. After 5 months, a CT scan was performed: after which the diagnosis of tuberculosis was removed, a new diagnosis was made: Williams-Campbell syndrome, moderate COPD, Generalized bronchiectasis. With a new diagnosis, he was sent to the Regional Hospital. Arriving at the regional hospital, I was diagnosed with bronchiectasis with localization of bronchiectasis in the upper and middle lobes of the right lung, the upper lobe of the left lung with pneumosclerosis of the lobes. Secondary obstructive bronchitis. Complication: VN-II-Ist. Concomitant disease: IDS with hyperfunction of the cellular link.
Now it’s been 4 years since my first pregnancy, I’m seeing a therapist, I’m in the hospital once a year. Worrying cough with sputum production, shortness of breath, fatigue. I constantly take expectorants, amoxiclav during exacerbations, and bronchomunal to maintain immunity. I plan to have a baby next year. I would like to consult with you about the treatment of my sore and pregnancy. Do I have a chance to give birth to a healthy child and how can I best prepare for this, and am I being treated correctly?

Answers Kucherova Anna Alekseevna:

Good afternoon. Hello Anna. The treatment is generally correct. I can only recommend inhalation of Lazolvan with Borjomi (or any other alkaline water) through a nebulizer (compression inhaler). I won’t say more details, since there is little information - blood tests, sputum cultures, spirography results. Unfortunately, pregnancy is contraindicated for you, as it will worsen the course of your disease. And the disease itself will have an extremely adverse effect on pregnancy. Sorry, but the chances of bearing a child are negligible, if at all. Sorry again. It's my opinion. I would recommend that you get another consultation from Prof. Vladimir Isakovich Bear at the Research Institute of PAG in Kyiv.
If you have any questions, call 095-274-58-47.

2011-02-19 16:50:34

Marina asks:

Hello, my mother has grade 4 COPD. She has given up on herself... Please tell me if there is anything I can do to help. Beg.

Answers:

Hello, Marina! Of course, your mother’s physical condition is very serious, but her psychological condition is much more worrying. Belief in recovery is a significant part of success in the treatment of any somatic disease, so something needs to be done about your mother’s condition. Try to interest her in the surroundings, in the events taking place, to return to her the desire to recover and move on with her life. Against the background of such a mood, the treatment prescribed by a pulmonologist will be much more effective. Take care of your health!

2010-12-07 11:49:30

NADYA asks:

Hello. I was diagnosed with COPD stage 1, I am 31 years old. please tell me this is a very serious disease? what are its consequences? What causes this disease? why is it dangerous? I do not smoke.

Answers Medical consultant of the website portal:

Hello, Nadezhda! The most common cause of the development of chronic obstructive pulmonary disease is chronic bronchopulmonary infection (frequently recurrent bronchitis, repeated pneumonia, etc.), chronic influence on the lungs of toxic substances and gases, as a result of which the reactivity of the bronchi is impaired, their ability to expand is reduced and increased – to narrowing, the structure and structure of the bronchial tree also changes. Hereditary predisposition plays an important role in the development of COPD. The main consequence of COPD is a decrease in the volume of air entering the patient's body. The main manifestations of COPD are cough - dry sludge with sputum, shortness of breath. The consequences of chronic obstructive pulmonary disease are emphysema, pneumosclerosis, the development of respiratory failure, and cor pulmonale. Adequate treatment and constant medical supervision with correction of risk factors reduces the rate of development of the disease and leads to long-term remission. COPD is treated by Take care of your health!

2015-06-16 20:14:17

Marina asks:

Hello! I underwent TM. I have a median disc herniation L4-L5 with prolapse posteriorly into the spinal canal by 7.3 mm. L5-S1 by 6.7 mm. I also have a diagnosis of coronary artery disease (IHD) Angina pectoris 3f.cl. hypertension 3. Art. AH3. risk 4 (very high) Atherosclosis of the vessels of the lower extremities. grade 4 obesity after the second operation. Ventricular and supraventricular extrasystole. Paroxysmal supraventricular tachycardia CH2B-3 (NYHA FC 4) CKD stage 2 thrombectomy from the brachial axillary artery on the right. COPD is moderate. remission DN0 symptomatic erythrocytosis.osteoporosis. gout. I walk to the kitchen and immediately sit down, I have to have a stake in my back. There is an exacerbation in the groin for a month, I can’t get up from the couch. Question? Is there anything that can help me?

2014-07-30 13:09:06

Natalya asks:

Hello. my father is 67 years old. Smoking experience: 40 years. Non-smoker for 2 years. Diagnosed with COPD stage 3. severe. Over the past year, the condition has worsened after undergoing treatment in a hospital. after light housework a severe cough and shortness of breath begin. leukocytes -9. ESR 28, hemoglobin 131. How can you relieve severe prolonged coughing attacks? how you can help a person. It’s very scary to watch someone suffocate. Are there emergency medications that should be on hand? piriva inhalers (at lunch), seretit 2p. per day (morning and evening), deredual in emergency cases (nebulizer) nebulizer with lazolvan or berodual - once a month for 10 days. What else do you recommend? Tell me how often to take Daxacas and for how long. I took this drug from July to January (6 months). I experienced depression. Is it possible to somehow compensate for this side effect? should I add ventolin and pulmicort or replace some? Tell me, please, about oxygen therapy. In the hospital, the oxygen level in the blood was measured at 97-98%. Is it necessary or possible to take it? What can you say about the ASTER physiotherapeutic device?

Answers Vasquez Estuardo Eduardovich:

Good day, Natalia! He should have thought about this a long time ago, when his body could still adapt to the fact that he was quitting smoking. Now we have what we have - a gross change in the lung tissue, bronchi and probably the entire cardiovascular system! Treatment is symptomatic, and ONLY under the supervision of the treating physician. No independent actions and not thinking that the treatment is not helping, but that a lot has been done before so that medicine is powerless for him.

2014-07-27 09:01:47

Natalya asks:

Hello. my father is 67 years old. Smoking experience: 40 years. Non-smoker for 2 years. Diagnosed with COPD stage 3. severe. Over the past year, the condition has worsened after undergoing treatment in a hospital. after light housework a severe cough and shortness of breath begin. leukocytes -9. ESR 28, hemoglobin 131. How can you relieve severe prolonged coughing attacks? how you can help a person. It’s very scary to watch someone suffocate. Are there emergency medications that should be on hand? piriva inhalers (at lunch), seretit 2p. per day (morning and evening), deredual in emergency cases (nebulizer) nebulizer with lazolvan or berodual - once a month for 10 days. What else do you recommend? Tell me how often to take Daxacas and for how long. I took this drug from July to January (6 months). I experienced depression. Is it possible to somehow compensate for this side effect? also tell me about aerophyllin - course of application, frequency? should I add ventolin and pulmicort or replace some?

Answers Shidlovsky Igor Valerievich:

Treatment cannot be prescribed in absentia. Cough needs to be looked at individually: for some, Lazolvan helps, for others, Acc, or Acc + Lazolvan (Helpex Breeze), and for others, antitussive Synecode. During exacerbations, seretide should be increased to the maximum, berodual 2 times a day, consider the need for intravenous or intramuscular dexamethasone, and antibiotics. Daxas is used either during exacerbations or long-term as planned if necessary. And keep in mind that tachycardia most likely exists on its own, and aerophylline also enhances it. Ventolin on demand. Consider oxygen therapy.

2014-07-23 11:54:27

Natalya asks:

Hello. my father is 67 years old. Smoking experience: 40 years. Non-smoker for 2 years. Diagnosed with COPD stage 3. severe. Over the past year, the condition has worsened after undergoing treatment in a hospital. after light housework a severe cough and shortness of breath begin. leukocytes -9. ESR 28, hemoglobin 131. How can you relieve severe prolonged coughing attacks? how you can help a person. It’s very scary to watch someone suffocate. Are there emergency medications that should be on hand? piriva inhalers (at lunch), seretit 2p. per day (morning and evening), deredual in emergency cases (nebulizer) nebulizer with lazolvan or berodual - once a month for 10 days. what else do you recommend?

Answers Nesterenko Elena Yurievna:

Good afternoon, Daxas 1t x 1 r/d, Aerophyllin 1t at night, Ventolin, Pulmicort in a nebulizer (first breathe Ventolin, then Pulmicort. Breathe as usual, not deeply, otherwise a strong heartbeat may occur).

2014-03-03 04:32:34

Anastasia asks:

Hello, we have been diagnosed with COPD, mixed type, moderate severity, exacerbation: complications: 3rd degree DN. Tell me if this is fatal and how to treat it

Answers Shidlovsky Igor Valerievich:

Stage 3 DN is already a severe degree of severity. Such an exacerbation can even be very dangerous. Treatment in a hospital setting: antibiotics, steroid hormones in droppers and in inhalers, aminophylline/theophylline, bronchodilators such as Berodual, Ventolin (ideally through a nebulizer), expectorants acetylcysteine ​​+ ambroxol (ideally both orally and through a nebulizer), oxygen therapy, sometimes therapeutic bronchoscopy and etc.

Chronic obstructive pulmonary disease (COPD) is a deadly disease. The number of deaths per year worldwide reaches 6% of the total number of deaths.

This disease, which occurs as a result of long-term damage to the lungs, is currently considered incurable; therapy can only reduce the frequency and severity of exacerbations and reduce the level of deaths.
COPD (chronic obstructive pulmonary disease) is a disease in which air flow in the airways is limited, partially reversible. This obstruction continually progresses, reducing lung function and leading to chronic respiratory failure.

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Who has COPD

COPD (chronic obstructive pulmonary disease) mainly develops in people with many years of smoking experience. The disease is widespread throughout the world, among men and women. The highest mortality rate is in countries with low living standards.

Origin of the disease

With many years of irritation of the lungs by harmful gases and microorganisms, chronic inflammation gradually develops. As a result, narrowing of the bronchi occurs and destruction of the alveoli of the lungs. Subsequently, all respiratory tracts, tissues and blood vessels of the lungs are affected, leading to irreversible pathologies that cause a lack of oxygen in the body. COPD (chronic obstructive pulmonary disease) develops slowly, progressing steadily over many years.

If left untreated, COPD leads to disability and then death.

Main causes of the disease

• Smoking is the main cause, causing up to 90% of cases of the disease;
• occupational factors - work in hazardous industries, inhalation of dust containing silicon and cadmium (miners, builders, railway workers, workers in metallurgical, pulp and paper, grain and cotton processing enterprises);
• hereditary factors - rare congenital α1-antitrypsin deficiency.

• Cough– the earliest and often underestimated symptom. At first, the cough is periodic, then it becomes daily, in rare cases it appears only at night;
• – appears in the early stages of the disease in the form of a small amount of mucus, usually in the morning. As the disease progresses, the sputum becomes purulent and increasingly abundant;
• dyspnea– is detected only 10 years after the onset of the disease. At first it appears only during severe physical exertion. Further, a feeling of lack of air develops with minor body movements, and later severe progressive respiratory failure appears.

The disease is classified according to severity:

Mild – with slightly pronounced impairment of lung function. A slight cough appears. At this stage the disease is very rarely diagnosed.

Moderate severity - obstructive disorders in the lungs increase. Shortness of breath appears during exercise. loads The disease is diagnosed when patients present due to exacerbations and shortness of breath.

Severe - there is a significant restriction of air flow. Frequent exacerbations begin, shortness of breath increases.

Extremely severe - with severe bronchial obstruction. The state of health deteriorates greatly, exacerbations become threatening, and disability develops.

Diagnostic methods

Anamnesis collection - with analysis of risk factors. For smokers, the smoker's index (SI) is assessed: the number of cigarettes smoked daily is multiplied by the number of years of smoking and divided by 20. An SI of more than 10 indicates the development of COPD.
Spirometry – to assess lung function. Shows the amount of air during inhalation and exhalation and the speed of entry and exit of air.

A test with a bronchodilator - shows the likelihood of reversibility of the process of bronchial narrowing.

X-ray examination - determines the severity of pulmonary changes. The same is carried out.

Sputum analysis - to identify microbes during exacerbation and select antibiotics.

Differential diagnosis

X-ray findings are also used to differentiate from tuberculosis, as well as sputum analysis and bronchoscopy.

How to treat the disease

General rules

• Smoking must be stopped forever. If you continue to smoke, no treatment for COPD will be effective;
• use of personal protective equipment for the respiratory system, reducing, if possible, the amount of harmful factors in the work area;
• rational, nutritious nutrition;
• reduction to normal body weight;
• regular physical exercise (breathing exercises, swimming, walking).

Treatment with drugs

Its goal is to reduce the frequency of exacerbations and severity of symptoms, and prevent the development of complications. As the disease progresses, the scope of treatment only increases. Main drugs in the treatment of COPD:

• Bronchodilators are the main drugs that stimulate bronchodilation (atrovent, salmeterol, salbutamol, formoterol). Administered preferably in the form of inhalations. Short-acting drugs are used as needed, long-acting drugs are used constantly;
• glucocorticoids in the form of inhalations - used for severe degrees of the disease, for exacerbations (prednisolone). In case of severe respiratory failure, attacks are stopped with glucocorticoids in the form of tablets and injections;
• vaccines – vaccination against influenza can reduce mortality in half of cases. It is carried out once in October - early November;
• mucolytics – thin mucus and facilitate its removal (carbocysteine, ambroxol, trypsin, chymotrypsin). Used only in patients with viscous sputum;
• antibiotics - used only during exacerbation of the disease (penicillins, cephalosporins, fluoroquinolones may be used). Tablets, injections, inhalations are used;
• antioxidants – capable of reducing the frequency and duration of exacerbations, used in courses of up to six months (N-acetylcysteine).

Surgery

• Bullectomy – removal can reduce shortness of breath and improve lung function;
• Reducing lung volume through surgery is currently under study. The operation improves the patient’s physical condition and reduces the mortality rate;
• Lung transplantation – effectively improves the quality of life, lung function and physical performance of the patient. Application is hampered by the problem of donor selection and the high cost of the operation.

Oxygen therapy

Oxygen therapy is carried out to correct respiratory failure: short-term - for exacerbations, long-term - for the fourth degree of COPD. If the course is stable, continuous long-term oxygen therapy is prescribed (at least 15 hours daily).

Oxygen therapy is never prescribed to patients who continue to smoke or suffer from alcoholism.

Treatment with folk remedies

Herbal infusions. They are prepared by brewing a spoonful of the collection with a glass of boiling water, and each is taken for 2 months:

√ 1 part sage, 2 parts each chamomile and mallow;

√ 1 part flax seeds, 2 parts each eucalyptus, linden flowers, chamomile;

√ 1 part each of chamomile, mallow, sweet clover, anise berries, licorice and marshmallow roots, 3 parts flaxseed.

• Radish infusion. Grate black radish and medium-sized beets, mix and pour cooled boiling water over them. Leave for 3 hours. Drink 50 ml three times a day for a month.
• Nettle. Grind the nettle roots into a paste and mix with sugar in a ratio of 2:3, leave for 6 hours. The syrup removes mucus, relieves inflammation and relieves cough.
• Milk:

√ Brew a spoonful of cetraria (Icelandic moss) with a glass of milk and drink throughout the day;

√ Boil 6 chopped onions and a head of garlic in a liter of milk for 10 minutes. Drink half a glass after meals. Every mother should know this!

Are coughing attacks keeping you up at night? You may have tracheitis. You can learn more about this disease

Secondary

• physical activity, regular and dosed, aimed at the respiratory muscles;
• annual vaccination with influenza and pneumococcal vaccines;
• constant intake of prescribed medications and regular examinations with a pulmonologist;
• correct use of inhalers.

Forecast

COPD has a conditionally unfavorable prognosis. The disease progresses slowly but constantly, leading to disability. Treatment, even the most active, can only slow down this process, but not eliminate the pathology. In most cases, treatment is lifelong, with constantly increasing doses of medication.

With continued smoking, obstruction progresses much faster, significantly reducing life expectancy.

Incurable and deadly, COPD simply encourages people to quit smoking for good. And for people at risk, there is only one piece of advice - if you notice signs of the disease, immediately contact a pulmonologist. After all, the earlier the disease is detected, the lower the likelihood of premature death.

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For effective treatment of chronic obstructive pulmonary disease (COPD) it is necessary.

Diagnostics

Bronchial asthma	COPD
Inflammation is localized in the small bronchi, without affecting the tissue of the lungs themselves	Inflammation is localized in the small bronchi, but spreads to the alveoli, destroying them and leading to the development of emphysema
Risk factors: allergens Family predisposition Common onset in children or young adults	Risk factors: smoking, occupational hazards Onset after age 35
Paroxysmal, reversible symptoms, lack of progression in mild forms	Steady increase in manifestations Often late diagnosis
Reversible bronchial obstruction according to spirometry	Irreversible bronchial obstruction according to spirometry

The main signs that help in the diagnosis of other lung diseases resembling COPD:

Disease	Characteristic signs
	Large volume of purulent sputum Frequent exacerbations Various dry and wet rales Signs of bronchiectasis on radiography or tomography
	Onset may be at a young age Characteristic radiological manifestations Detection of mycobacteria in sputum High prevalence of the disease in the region
Bronchiolitis obliterans	Starting in young people Presence of rheumatoid arthritis or acute gas poisoning
Diffuse panbronchiolitis	Onset in non-smoking men The majority have concomitant sinusitis (sinusitis, etc.) Specific signs on the tomogram
Congestive heart failure	Existing heart disease Characteristic wheezing in the lower parts of the lungs Spirometry shows no obstructive disorders

Treatment of COPD

Therapy is aimed at relieving symptoms, improving quality of life and exercise tolerance. In the long term, treatment aims to prevent the progression and development of exacerbations and reduce mortality.

Non-pharmacological treatment:

• to give up smoking;
• physical activity;
• vaccination against influenza and pneumococcal infection.

Drug treatment

The following groups of drugs are used in the treatment of stable COPD:

• bronchodilators;
• combination of bronchodilators;
• inhaled glucocorticoids (IGCS);
• combination of inhaled corticosteroids and long-acting bronchodilators;
• phosphodiesterase type 4 inhibitors;
• methylxanthines.

Let us remind you that a doctor must prescribe treatment; self-medication is unacceptable; Before starting therapy, you should read the instructions for use and ask your doctor any questions you may have.

• for moderate exacerbation - azithromycin, cefixime;
• for severe exacerbation - amoxiclav, levofloxacin.

If respiratory failure develops, oxygen and non-invasive ventilation are prescribed; in severe cases, treatment includes transfer to artificial ventilation.

Rehabilitation of patients

Pulmonary rehabilitation should last at least 3 months (12 sessions twice a week, lasting 30 minutes). It improves exercise capacity, reduces shortness of breath, anxiety and depression, prevents exacerbations and hospitalization, and has a positive effect on survival.

Rehabilitation includes treatment, physical training, nutritional correction, patient education, support from social workers and a psychologist.

The main thing in rehabilitation is physical training. They should combine strength and endurance exercises: walking, exercises with expanders and dumbbells, a step machine, cycling. Additionally, breathing exercises are used, including with the help of special simulators.

Nutrition correction consists of normalizing weight, sufficient amounts of protein, vitamins and microelements in the diet.

Patients need to be taught the skills to assess their condition, recognize deterioration and methods of correction, and also emphasize the need for ongoing treatment and monitoring by a doctor.

Read more about rehabilitation of patients with COPD

Chronic obstructive pulmonary disease (COPD) is a disease accompanied by impaired ventilation of the lungs, that is, the flow of air into them. In this case, the disruption of air supply is associated precisely with an obstructive decrease in bronchial patency. Bronchial obstruction in patients is only partially reversible; the lumen of the bronchi is not completely restored.

The pathology has a gradually progressive course. It is associated with an excessive inflammatory and obstructive response of the respiratory system to the presence of harmful impurities, gases, and dust in the air.

Chronic obstructive pulmonary disease - what is it?

Traditionally, the concept of COPD includes obstructive bronchitis and emphysema (bloating) of the lungs.

Chronic (obstructive) bronchitis is an inflammation of the bronchial tree, which is determined clinically. The patient has a cough with sputum. Over the past two years, a person must have coughed for a total of at least three months. If the duration of the cough is shorter, then the diagnosis of chronic bronchitis is not made. If you have, consult a doctor - early initiation of therapy can slow down the progression of the pathology.

Prevalence and significance of chronic obstructive pulmonary disease

Pathology is recognized as a global problem. In some countries, it affects up to 20% of the population (for example, in Chile). On average, among people over 40 years of age, chronic obstructive pulmonary disease occurs in approximately 11–14% of men and 8–11% of women. Among the rural population, pathology occurs approximately twice as often as among urban residents. With age, the incidence of COPD increases, and by the age of 70, every second male rural resident suffers from obstructive pulmonary disease.

Chronic obstructive pulmonary disease is the fourth leading cause of death in the world. Mortality from it is increasing, and there is a tendency towards an increase in mortality from this pathology among women.

The economic costs associated with COPD rank first, surpassing the costs of treating patients with asthma by half. The greatest losses occur in inpatient care for patients with an advanced stage, as well as in the treatment of exacerbations of the obstructive process. Taking into account temporary disability and reduced performance when returning to work, economic losses in Russia exceed 24 billion rubles per year.

Chronic obstructive pulmonary disease is an important social and economic problem. It significantly impairs the quality of life of an individual patient and places a heavy burden on the healthcare system. Therefore, prevention, timely diagnosis and treatment of this disease are very important.

Causes and development of COPD

In 80–90% of cases, the cause of chronic obstructive pulmonary disease is smoking. The group of smokers has the highest mortality rate from this pathology; they experience faster irreversible changes in pulmonary ventilation and more pronounced symptoms. However, pathology also occurs in non-smoking people.

An exacerbation can develop gradually, or it can occur suddenly, for example, against the background of a bacterial infection. A severe exacerbation may result in the development of acute heart failure.

Forms of COPD

The manifestations of chronic obstructive pulmonary disease largely depend on the so-called phenotype - the set of individual characteristics of each patient. Traditionally, all patients are divided into two phenotypes: bronchitis and emphysematous.

With the bronchitis obstructive type, the clinical manifestations of bronchitis predominate - cough with sputum. In the emphysematous type, shortness of breath predominates. However, “pure” phenotypes are rare, and there is usually a mixed picture of the disease.

Some clinical signs of phenotypes in COPD:

In addition to these forms, other phenotypes of obstructive disease are distinguished. So, recently a lot has been written about the overlap phenotype, that is, the combination of COPD and. This form develops in patients with asthma who smoke. It has been shown that about 25% of all patients with COPD have reversible COPD, and eosinophils are found in their sputum. In the treatment of such patients, the use is effective.

A form of the disease is distinguished that is accompanied by two or more exacerbations per year or the need for hospitalization more than once a year. This indicates a severe course of the obstructive disease. After each exacerbation, lung function worsens. Therefore, an individual approach to the treatment of such patients is necessary.

Chronic obstructive pulmonary disease causes the body to respond in the form of systemic inflammation. It primarily affects skeletal muscles, which increases weakness in patients with COPD. Inflammation also affects blood vessels: the development of atherosclerosis accelerates, the risk of coronary heart disease, myocardial infarction, and stroke increases, which increases mortality among patients with COPD.

Other manifestations of systemic inflammation in this disease are osteoporosis (decreased bone density and fractures) and anemia (decreased amount of hemoglobin in the blood). Neuropsychiatric disorders in COPD include difficulty falling asleep, nightmares, depression, and memory impairment.

Thus, the symptoms of the disease depend on many factors and change throughout the patient’s life.

Read about the diagnosis and treatment of obstructive disease.