This name of a terrible disease appeared in Russia about 20 years ago. Previously it was called bronchial asthma, emphysema, chronic bronchitis ...

Under the mysterious abbreviation COPD (chronic obstructive pulmonary disease), there is a dangerous disease that cannot be cured completely if you miss the beginning of its development. In the modern world, it ranks third in the number of deaths after cardiovascular and oncological diseases. In European countries, for every 100 thousand population, there are up to 40 deaths from COPD per year.

The main causes of the disease

Risk factors for COPD are different. Critical to health are:

• long-term active smoking,
• industrial hazards,
• unfavorable ecology.

Smokers make up the majority of the COPD risk group. The main reason lies in tobacco smoke. A huge amount (more than 500) of harmful components in tobacco, when inhaled, causes irritation of the bronchial mucosa. Long-term negative effects cause inflammation, eventually developing COPD. Not only smokers themselves suffer, but also households (including children), and non-smoking colleagues: secondhand smoke can also lead to this ailment.

The occurrence of COPD can also be due to occupational factors that contribute to the development of the disease. They can include inhalation of toxic fumes, working in dusty environments, contact with harmful metals (for example, with cadmium or silicon). The occupational risk group includes workers in the chemical industry, construction trades, road workers, miners.

Unfavorable ecology can negatively affect health not only during walks (inhalation of exhaust gases from cars, products of any combustion, strong wind with dust), but also at home. If the house is not heated by coal and the hostess cooks food on an electric stove, and not on a gas stove, then all households have a reduced risk of developing lung obstruction.

Signs of COPD

1. Shortness of breath and cough with sputum discharge are early symptoms of the disease. The cough usually hurts in the morning. But it can also occur against the background of an infection. In any case, it is necessary to visit a doctor for an accurate diagnosis.
2. It's natural to feel short of breath after strenuous exercise. But if she bothers as a result of the most ordinary actions, then you need to go to an appointment with a pulmonologist or therapist to diagnose the disease based on the symptoms.

There is a modern gradation according to the severity of COPD.

1. Mild, grade 1 COPD is rapid breathing when walking quickly or when climbing low altitudes.
2. Moderately severe, grade 2 COPD - a sick person has difficulty walking fast, he has to walk slowly even on a flat surface. Based on the general condition of the patient, it is possible that disability in case of COPD of the III group of this degree will be formalized.
3. Severe, grade 3 COPD - the patient begins to choke after minutes of walking on a flat surface. The members of the commission will give II or III disability group (the disability group will depend on his general condition).
4. Very severe shortness of breath, COPD of the 4th degree - the patient suffocates even during normal activities or going out into the street, he cannot serve himself. Gradually, his condition is getting worse, complications arise. With COPD of this degree, the first disability group is formed.

In COPD, disability is given on the basis of a medical certificate of the presence of a severe degree of the disease... In addition, it is taken into account how able a person is, whether he has been transferred to a lower-paid position, whether he can serve himself and, if necessary, provide himself with emergency assistance.

If the patient is not able to independently get to the inhaler or call a doctor by phone, then there is a high probability of death from COPD. To exclude a lethal outcome, a disabled person needs the help of a nurse or a loved one.

Complications

Complications of COPD are just as dangerous as the disease itself. Like any chronic inflammation, this disease has a negative effect on the body's systems and leads to a number of consequences such as:

• pneumonia;
• respiratory failure;
• increased pressure in the pulmonary artery (often a reason for hospitalization, can even lead to the death of the patient);
• ischemic heart disease (CHD);
• the appearance of atherosclerotic plaques on the walls of blood vessels (this can be the starting point for the development of epilepsy) and the formation of blood clots;
• development of bronchial inferiority;
• cor pulmonale - expansion of the right ventricle of the heart;
• arrhythmia.

Video

Video - who is at risk of getting COPD?

Life expectancy in COPD

In COPD, life expectancy depends entirely on whether the severity of the disease is correctly determined and whether treatment is started on time. At the beginning of the development of this insidious disease, the prognosis for a complete cure is very favorable: there is an opportunity to say goodbye to it forever and live fully. But not all sick people go to the doctor with a complaint of a wet cough. After all, smoker's bronchitis is the norm for prolonged smoking, as smokers themselves believe.

If there is no appropriate medical care, then the prognosis of the course of the disease is disappointing: the disease will only progress, this will certainly lead the patient to disability. But thanks to the right treatment, you can stabilize the course of the disease. Such people can live long lives.

How long patients with COPD live depends on their condition and timeliness of treatment - some of them live for several decades, and some much less. Life expectancy is negatively affected by such factors as oxygen starvation of the blood, the presence of arrhythmias, disorders in the right heart, and high pulmonary pressure.

How and how to treat the disease

Prevention of COPD, like any disease, comes first in its treatment.

It assumes compliance with the rules:

1. Most importantly, you need to urgently and permanently quit smoking, otherwise any treatment for COPD will not be effective.
2. The use of a respirator for respiratory protection, reducing the number of harmful factors in the workplace. If these conditions cannot be met, it is necessary to change the place of work.
3. A complete and healthy diet with sufficient protein and vitamins.
4. Regular breathing exercises, swimming, walking - at least 20 minutes a day.

All of the above, together with the use of medicines and folk remedies, will improve the condition and be able to give a chance for recovery.

Drug treatment

The goal of drug treatment is to reduce the frequency of exacerbations (it is during exacerbations that most patients die) and to prevent complications. An exacerbation of COPD can be caused by several reasons: damp cool weather, respiratory infections (bacterial, viral). As the disease progresses or during an exacerbation, the amount of treatment increases.

Basic drugs:

• Bronchodilators are the main drugs that dilate the bronchi (these include atrovent, formoterol, salbutamol, berodual). Berodual is the most popular: it has a minimum of side effects. But overdose should not be allowed, you must strictly follow the recommendations in the instructions. It is recommended to monitor the heart rate (HR): it should be no more than 90 beats per minute. Bronchodilators are used in most cases in the form of inhalation.
• Glucocorticosteroids (GCS) are used to treat severe disease or exacerbations ( prednisone, budesonide). For severe respiratory failure, glucocorticosteroids are administered by injection to relieve attacks

• Mucolytics are taken to dilute phlegm and facilitate its excretion ( carbocisteine, ambroxol, bromhexine, ACC). Used only for viscous mucus.
• Vaccines. Vaccination against influenza and pneumonia can significantly reduce the risk of mortality. It is carried out annually before the winter period.
• Antibiotics are used only with exacerbation of the disease - in the form of tablets, injections, inhalations.
• Antioxidants reduce the duration and severity of exacerbations, but are used in long courses - up to six months.

It must be remembered that all drugs are prescribed only by a doctor.

Surgery

Bullectomy. Resection (removal) of that part of the lung that can no longer perform its function, can reduce shortness of breath, improve the general condition of the patient.

Transplantation effectively increases the patient's performance, improves lung function. But the disadvantage of this operation is its high cost and the problem with finding a donor.

Oxygen therapy

Oxygen therapy is prescribed either to patients with the fourth degree of COPD, or during exacerbations to restore the respiratory function of the lungs, or if drug treatment of the disease has not yielded the desired results.

Important ! Oxygen therapy is never prescribed to people who smoke or are susceptible to alcoholism.

With the development of COPD, oxygen deprivation of tissues increases. For this reason, additional oxygen therapy is necessary (with arterial oxygen saturation less than 88%). Therapy should be continued for at least 15 hours a day. Indications for oxygen therapy are cor pulmonale, edema, thick blood.

Patients with sufficiently "tolerant" ventilation disorders can afford to perform the procedure at home. But the selection of modes is carried out only by a specialist.

Other respiratory therapies

Percussion drainage is a fairly new technique. It is based on the supply of small portions of air to the bronchi at the right pressure and with a set frequency. The patient immediately feels relief of breathing.

Respiratory gymnastics according to the Strelnikova method, inflating balls, exhaling through the mouth through a tube dipped in water, will serve as a useful addition to medications.

Rehabilitation centers provide assistance to all patients with COPD, starting with the 2nd degree of severity. They teach breathing exercises, physical exercises, and if the patient takes oxygen therapy sessions at home, they teach them how to conduct them correctly. Specialists will also provide psychological assistance to patients, help them switch to a healthy lifestyle, teach them how to quickly seek medical help or provide it on their own.

Folk remedies for the treatment of COPD

Treatment of COPD with medications is recommended in conjunction with medications. Otherwise, you should not expect a good result from the use of traditional medicine recipes. Below are simple, but effective folk recipes for obstructive bronchitis that can help in the treatment of COPD.

Herbal infusions. They are prepared by brewing a tablespoon of the collection with a glass of boiling water, each taken within 2 months.

• Take 100 g of flax seeds, 200 g each of chamomile and linden flowers. Insist half an hour. Consume half a glass once a day.
• 200 g nettle, 100 g sage. Insist for about an hour. Take half a glass twice a day.
• 300 g of flax seeds, 100 g each of chamomile flowers, licorice roots, marshmallow, anise berries. Collection to insist half an hour. Drink half a glass once / day.
• Take one part sage and two parts chamomile and mallow. Insist half an hour. Drink half a glass twice a day.
• One part flaxseed, two parts each eucalyptus, linden flowers, chamomile. Insist half an hour. Drink half a glass twice a day.
• 2 tsp brew anise seeds with 400 ml of boiling water, leave for 20 minutes to infuse. Consume the entire infusion in four doses per day.

Inhalation. For their implementation, you can use decoctions of herbs (chamomile, oregano, mint, pine needles), a solution of sea salt, finely chopped onions, essential oils (coniferous or eucalyptus).

At the current level of development of medicine, it is possible not only to facilitate the course of chronic obstructive pulmonary disease, but also to prevent the appearance of the disease itself.

A healthy lifestyle, proper nutrition, physical education, and respiratory exercises will help to provide a positive prognosis in curing the disease.

Among the pathologies to which the organs of the respiratory system are susceptible, obstructive lesions stand apart, due to the specifics of clinical manifestations. For this reason, such diseases are little known, and patients are often frightened, and not without reason, when they are diagnosed with COPD. Our experts will tell you what it is and how it is treated.

Under the obscure abbreviation COPD hides chronic obstructive pulmonary disease - a progressive disease characterized by irreversible processes in the tissues of all parts of the respiratory system.

According to the standards of the World Health Organization, the ICD 10 code for COPD means that according to the International Classification of Diseases of the tenth revision, the disease belongs to the category of respiratory organs.

Activities to reduce the number of factors that reduce the risk of developing COPD are considered a priority by WHO experts.

To understand how serious such lung lesions are for health, it is not necessary to delve into the deep processes that arise during the development of COPD. What kind of disease it is becomes clear from his prognosis - there is practically no chance of recovery.

Clinical picture

A characteristic feature of COPD is the modification of the structure of the bronchi, as well as lung tissue and blood vessels. As a result of exposure to irritating factors, inflammatory processes occur on the bronchial mucosa, which reduce local immunity.

Against the background of inflammation, the production of bronchial mucus becomes more intense, but its viscosity increases, making it difficult to remove secretions naturally. For bacteria, such stagnation is the best stimulant for development and reproduction.

Due to bacterial activity, the patency of bronchial communications connecting the alveoli with air, the structure of the trachea and lung tissue is gradually disrupted.

Further progress of the disease leads to irreversible processes that cause the development of fibrosis and emphysema:

• swelling of the bronchial mucosa;
• spasms of smooth pulmonary muscles;
• increased secretion viscosity.

These pathologies are characterized by the proliferation of connective tissue and abnormal expansion of the distal areas filled with air.

Provoking factors

Harmful factors are the basis for the onset of COPD. One of the main factors causing irreversible lung obstruction is smoking. It is in vain that smokers think that for many years of adherence to a bad habit, their health remains the same. The prerequisites for the development of the disease are formed for more than one day, and not even a year - most often, a disappointing diagnosis is given to those over 40.

Passive smokers are also at risk.

Inhalation of tobacco smoke not only irritates the mucous membrane of the respiratory tract, but also gradually destroys their tissues. Loss of elasticity of the fibers of the alveoli is one of the first signs of developing obstruction. However, at this stage, the symptoms of the disease are not sufficiently pronounced for a sick person to turn to medicine for help.

Additional triggers of COPD:

• respiratory tract infections;
• inhalation of harmful substances or gases;
• pathogenic impact of the professional environment;
• a genetic predisposition to damage to the lung tissue by elastase, due to a deficiency of the alpha-1-atrypsin protein.

The onset and development of COPD is not associated with the course of other chronic processes in the respiratory system. But it belongs to a number of professional pathologies affecting metallurgists, construction workers, miners, railroad workers, workers in pulp processing enterprises, as well as agricultural workers involved in the processing of grain and cotton.

COPD ranks fourth among the main pathologies of the working-age population in terms of the number of deaths.

Features of the classification

The classification of COPD provides for four stages in the development of pathology, determined by the level of complexity of its course. The main criteria for stratification are the presence of characteristic symptoms, as well as the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), recorded after inhalation with a bronchodilator.

The main stages of the course of COPD:

• easy. The functionality of external respiration is normal. The ratio between FEV1 and FVC is less than 70% of the norm, which is regarded as a sign of early development of bronchial obstruction. Chronic symptoms may not be observed;
• average. Respiratory function indicators are less than 80%. The ratio between FEV1 and FVC is less than 70% of the norm, which confirms the progress of the obstruction. The cough gets worse. Other characteristic symptoms of the disease are present;
• heavy. The RVF1 indicators are less than 50% of the norm. The ratio of FEV1 and FVC is less than 70% of the norm. It is accompanied by severe cough, profuse sputum and significant shortness of breath. Attacks of exacerbations appear;
• extremely hard. The functionality of external respiration is provided by less than 30%. It is characterized by the appearance of respiratory failure and the development of pulmonary heart with abnormal expansion of the right-sided heart.

The only thing that a sick person can do is to diligently follow all the recommendations of doctors in order to slow down the progress of the disease and improve overall well-being. The best that a healthy person can and should do is to prevent the onset of the disease by making efforts to provide preventive measures.

Symptoms of chronic obstructive pulmonary disease

The characteristic signs of the development of COPD appear at the stage of moderate severity of the course. Until the onset of advanced stages, the disease proceeds in a latent form and may be accompanied by a small episodic cough. As the pathology develops, the secretion of mucous sputum joins the cough.

About ten years after the onset of early symptoms, shortness of breath develops - a feeling of shortness of breath accompanies physical activity. Over the years, the intensity of shortness of breath increases. In severe COPD, shortness of breath causes the person to stop every hundred meters. With an extremely severe form of the disease, the patient is not able not only to leave the house on his own, but also to change clothes.

Severe symptoms of COPD occur when the development of pathology reaches a severe phase:

• coughing attacks become prolonged and regular;
• the volume of secreted mucous sputum increases significantly, with the onset of an extremely severe stage, pus appears in the sputum;
• shortness of breath occurs even at rest.

Pathological processes characteristic of the course of COPD lead to pathophysiological changes in all parts of the respiratory system and are accompanied by systemic manifestations in the form of skeletal muscle dysfunction and loss of muscle mass.

Clinical forms

Depending on the intensity of the expression of the symptoms of the disease and their characteristics, two clinical forms of COPD are distinguished - bronchial and emphysema.

The main criteria for determining the clinical form are applicable only at the last stages of the development of pathology:

• prevalence of cough, shortness of breath;
• the severity of bronchial obstruction;
• the severity of hyperventilation of the lungs - weak or strong;
• cyanosis color - blue or pinkish gray;
• the period of formation of the pulmonary heart;
• the presence of polycythemia;
• the severity of cachexia;
• age at which death is possible.

Loss of physical performance as well as disability is an inevitable consequence of the progress of COPD.

Chronic obstructive disease treatment:

Due to the fact that timely diagnosis is not possible, treatment of COPD is most often started at the onset of a moderate or severe stage. Collecting anamnesis involves identifying individual risk factors - determining the smoker's index, the presence of infections.

For differential diagnosis with bronchial asthma, parameters characterizing shortness of breath when exposed to a provoking stimulus are studied.

To confirm the diagnosis, spirometry is performed - the measurement of volumetric and speed characteristics of respiration to determine its functionality.

As additional diagnostic measures are used:

• sputum cytology,
• a blood test to detect polycythemia;
• blood gas analysis;
• x-ray of the lungs;
• bronchoscopy.

Only after clarifying the diagnosis and determining the stage and form of the disease, treatment is prescribed.

In remission

During periods of decline in acute manifestations of COPD, patients are advised to use bronchodilators, which increase the lumen of the bronchi, mucolytics, thinning sputum, and inhaled glucocorticosteroids.

With exacerbations

The exacerbation phase of COPD is characterized by a sharp and significant deterioration in the patient's well-being and lasts about two days. To reduce the intensity of the manifestations of the disease, pulmonologists prescribe antibiotic therapy.

The choice of antibiotic preparations is carried out taking into account the type of bacterial flora inhabiting the lungs. Preference is given to drugs that combine penicillins and clavulanic acid, respiratory fluoroquinolones, and second-generation cephalosporins.

In the elderly

Treatment of COPD in the elderly consists not only in the use of drug therapy, but also in the use of folk remedies, providing aerobic exercise and preventive measures, including smoking cessation and correcting respiratory failure.

Traditional methods and remedies for COPD treatment

The application of the recommendations of traditional medicine for COPD has several goals:

• mitigation of symptoms;
• slowing down pathological progress;
• launching regeneration mechanisms;
• restoration of the patient's vitality.

Inhalation based on plant raw materials - oregano, mint, calendula, chamomile, as well as essential oils of pine and eucalyptus - are considered the most effective way of affecting tissues affected by COPD.

To enhance the therapeutic effect, infusions of anise seeds, pansies, marshmallow, lungwort, plantain, heather, Icelandic moss, thyme and sage are used.

Breathing exercises

Aerobic loads and a set of breathing exercises form the basis for the rehabilitation of patients with COPD. Thanks to breathing exercises, weakened intercostal muscles are included in the breathing process, the smooth muscles of the lungs are strengthened, and at the same time, the psychological state of the patient improves.

One of the exercises: inhale with your nose and at the same time raise your arms up, bend your back and take your leg back. Then exhale with your mouth and return to the starting position. When repeating the exercise, then the left and then the right leg are taken alternately.

Exercise is only allowed during remission.

Prevention of COPD

The basis for the prevention of COPD is considered smoking cessation, since it is tobacco smoke that provokes the appearance of destructive processes in the lungs.

In addition, the following measures will help eliminate the likelihood of developing COPD:

• compliance with labor protection requirements for hazardous work;
• protection of the respiratory system from contact with substances hazardous to health;
• strengthening immunity - physical activity, hardening, adherence to the daily regimen;
• healthy food.

In order to prevent COPD, the World Health Organization has developed a convention to combat the globalization of the spread of tobacco products. The agreement was signed by representatives of 180 countries.

Individuals with COPD have different lifespans, depending on a number of factors. The most important of these are the presence of concomitant complications in the form of heart disease and the level of pressure in the pulmonary artery. COPD has the following definition: chronic obstructive pulmonary disease. This pathology occurs mainly in experienced smokers. In addition, it is caused by exposure to harmful chemicals and dust. Genetic predisposition also plays a role. The disease is characterized by constant progression, and its exacerbation often occurs. Therefore, the question of how long such patients live is very relevant.

The disease has a chronic course and is characterized by a decrease in the volume of air entering the lungs. It is caused by narrowing of the bronchial lumen. According to statistics, men over 40 years old, smokers with experience are more affected by this disease. But since recently the number of actively smoking women has sharply increased, their proportion among the sick has also increased. Chronic obstructive pulmonary disease is not completely cured, you can only stop its progression and thus prolong the patient's life. The first symptom of the disease is shortness of breath.

Stages and symptoms of the disease affecting the patient's life

In the clinical picture of COPD, symptoms such as increased sputum production, severe cough, and shortness of breath are present. This symptomatology is caused by inflammation in the lungs and obstruction. These symptoms are present in the initial stages of the disease, at later stages they are joined by problems in the work of the heart and pain in the bones. COPD often combines symptoms and signs of pulmonary emphysema and obstructive bronchitis.

At the onset of the disease, the cough bothers the patient mainly after a night's sleep, later it becomes permanent. Dry cough, accompanied by profuse expectoration. Shortness of breath is associated with difficulty exhaling.

Depending on the severity of the symptoms, 4 stages of the disease are distinguished:

1. The first stage of the disease is mild, manifested in episodic bouts of dry cough. Shortness of breath appears only with significant physical exertion. There is no pronounced deterioration in well-being. Detection of COPD at this stage and treatment will help maintain the patient's normal duration and quality of life. Reliable diagnosis during this period of the disease is carried out only by 25%.
2. The stage of moderate severity is characterized by certain limitations that the disease imposes on the patient. So, there is a pronounced impairment of the functioning of the lungs and shortness of breath, even with minor loads. Cough worries more and more often, especially in the morning. The patient is prescribed medication. The prognosis for life at this stage is less favorable.
3. Severe stage - the patient complains of symptoms such as constant shortness of breath and shortness of breath. Cyanosis of the skin and complications in the work of the heart are manifested, exacerbation often occurs. On average, patients with similar manifestations live no more than 8 years. In the case of additional diseases or if an exacerbation of COPD occurs, the mortality rate reaches 30%.
4. The last is a very difficult stage of the disease: most of the sick at this stage live no more than a year. They need constant medication to keep them alive. Often there is a need for artificial ventilation. All symptoms of the disease, especially cough and shortness of breath, are maximally pronounced. In addition, all sorts of complications join.

There are also such forms of the disease as emphysematous, bronchitic and mixed.

Life expectancy of patients

What is the prognosis for life expectancy for people with COPD? A timely diagnosis has a direct impact on the life expectancy of patients with such a diagnosis. Quite often, the reduction in the life span of people with this disease occurs due to late diagnosis.

Most patients do not seek qualified medical care in time, and therefore there is a late treatment and high premature mortality. In the absence of proper treatment, the prognosis is always poor, since the disease is steadily progressing. But if you consult a doctor in time and start adequate treatment, then the life expectancy of such patients increases significantly. COPD can be diagnosed by spirometry, X-ray, ultrasound of the heart, ECG, fibrobronchoscopy. In addition, the doctor will perform a physical examination and order a laboratory blood test.

Chronic obstructive pulmonary disease significantly impairs the patient's daily life, depriving him of the opportunity to fully perform basic household skills.

Nevertheless, the life of such patients is different, some live longer, others less. The prognosis depends on certain factors that directly affect the duration of their life. Among them:

• the presence of heart hypertrophy;
• the pressure of the pulmonary trunk is higher than normal;
• heart rate level;
• low oxygen content in the blood.

Since the methods and effectiveness of the treatment carried out directly affect the quality and duration of life of patients, they must strictly comply with all the prescriptions of the attending physician. In particular, they are strictly shown:

• to give up smoking;
• a special diet that includes food enriched with proteins and vitamins;
• playing sports;
• special breathing exercises;
• weight loss in the presence of excess;
• drug treatment.

How to increase life expectancy?

The incidence and mortality of people from chronic obstructive pulmonary disease throughout the world remains high. Treatment measures are aimed at achieving the following goals:

• lower mortality rates;
• decrease in the severity of symptoms;
• improving the quality of life of patients;
• facilitating exercise tolerance;
• prevention of exacerbations and complications.

Within the framework of drug treatment, drugs are used that act to improve sputum discharge and bronchial patency (bronchodilators and mucolytics). Corticosteroids are also given to reduce pulmonary edema (prednisolone) and antibiotics, especially if there is an exacerbation.

Videos about COPD and how to detect it:

In the absence of positive dynamics under the influence of such treatment, surgical methods are used. They are aimed at reducing the volume of the lungs, thereby relieving acute symptoms, or lung transplantation.

One of the most common pathologies that cause permanent inflammation of the respiratory system is chronic obstructive pulmonary disease (COPD for short). Although the term itself began to be used relatively recently, the number of patients with this disease is quite impressive (approximately 5-10% of the population). Such disappointing statistics is primarily due to the huge mass of smokers - they constitute the overwhelming number of patients.

Since the disease is often detected already in the last stages, mortality within 10 years after going to a doctor is 55% of all recorded cases. In addition, its complications often lead to loss of performance and disability. Therefore, it is imperative that a timely diagnosis and treatment of COPD be initiated.

COPD is a disease in its own right. It is characterized by a restriction of air passage through the respiratory tract, and in some cases this process is irreversible. This pathological condition is caused by inflammation of the lung tissue, in turn due to the nonspecific response of the patient's body to some pathogenic microparticles or gases.

COPD diagnosis is a collective term that includes:

• chronic obstructive bronchitis (including purulent);
• pneumosclerosis;
• pulmonary hypertension;
• emphysema resulting from a violation of the patency of the bronchial tree;
• chronic cor pulmonale.

All of these diseases reflect structural changes and dysfunction of key body systems that occur at different stages of COPD. Some have signs of several pathological conditions at once.

The reasons

In most cases, chronic obstructive pulmonary disease develops in people after 40. The majority of patients are men. This selective effect is based on the specific etiology of the disease. There are the following reasons for its occurrence:

• Smoking. It is the main culprit of COPD (more than 80% of patients), and this is typical mainly for developed countries, since the percentage of smokers there is higher. They develop dyspnea and respiratory obstruction much faster. A fairly high percentage of the risk of getting sick also exists among those who are regularly exposed to secondhand smoke. This is especially harmful for children.
• Professional factors... These include some areas of the industry, the by-product of which is the release of micro-dust particles with a high content of silicon and cadmium into the air. These are the mining and metallurgical industries, the cellulose industry, as well as work directly related to the production and use of cement.
• Hereditary pathologies... The genetic causes of the development of chronic obstructive pulmonary disease are still under study, but it is already reliably known that one of them is the lack of α1-antitrypsin. It controls the activity of elastase, which is involved in the breakdown of various protein structures. If production of this protein body is reduced by more than 30%, elastase begins to destroy lung tissue, causing emphysema.

There are several other factors that are believed to lead to this disease. These include underweight, air pollution, familial illness, and regular inhalation of biofuel combustion products during cooking (observed in people living in backward countries).

Prematurity and frequent acute respiratory infections in children can also lead to the development of the disease, although there is no statistics on the frequency of cases at this age. At the same time, COPD is recorded in adolescents as a consequence of bronchial asthma (according to some sources, the frequency is 4-10%).

Of course, the above risk factors, when present in isolation, are unlikely to cause chronic obstructive pulmonary disease. But since in the modern world with a developed industry, high air pollution and other consequences of human life, they act together with improper diet and bad habits. Therefore, the number of diseases is increasing every year, and the life expectancy of patients due to untimely detection in the general percentage decreases.

Development mechanism

The pathogenesis of the disease originates from the bronchial walls. Under the influence of external factors, the functioning of the exocrine apparatus is disrupted, which leads to increased secretion of mucus and a change in its composition. After a while, an infection occurs, which causes an inflammatory process that takes on a permanent form.

Since chronic obstructive pulmonary disease is progressive, the pathogenic microflora gradually destroys the tissues of the bronchi, bronchioles and adjacent alveoli. This course of the disease leads to a decrease in the supply of oxygen to the body, which, in turn, has an extremely negative effect on the work of all its systems. In this case, the heart experiences the greatest stress, as a result of which the functioning of the respiratory organs is greatly impaired.

Classification

The wording of the diagnosis is largely based on the severity of the disease. For this, the reduction in the flow rate of the inhaled air is determined and, on the basis of the data obtained, the so-called Tiffno index is calculated - an indicator of a possible decrease in the throughput of the patient's respiratory tract.

A special device is used for measurements - a spirometer. It will help you find out the two main values \u200b\u200bon the basis of which COPD is classified: forced expiratory volume (FEV) and forced vital capacity (FVC). Their percentage is the Tiffno index.

In addition, it is necessary to take into account the symptomatic manifestations and the frequency of exacerbations of the disease. In modern medicine, there are 4 degrees of severity of chronic obstructive pulmonary disease:

• It proceeds easily, manifests itself as a periodic wet cough. Dyspnea is not observed in most cases. FEV / FVC<70% от исходного значения. ОФВ>80% of the norm.

• Moderate course of the disease with noticeable dyspnea on exertion and persistent cough. Obstruction increases, possibly exacerbation of COPD. FEV / FVC<70%, ОФВ<80% от должного.

• The disease is characterized by severe symptoms. The patient has a constant wet cough, wheezing in the sternum, the slightest physical exertion causes severe shortness of breath. Periods of exacerbation occur regularly. FEV / FVC<70%, ОФВ<50% от исходного значения.

• The condition is extremely serious, in some cases even life-threatening. Obstruction of the bronchi is pronounced,. At this stage, destructive processes in the body lead to disability. FEV / FVC<70%, ОФВ<80% от нормы.

Starting from stage 3, COPD can be divided into two types, depending on the clinical manifestations:

• Bronchodilator... Cough is the predominant symptom here. At the same time, it is pronounced. Since cor pulmonale develops early, the skin acquires a bluish color over time. The concentration of erythrocytes in the blood, as well as its total volume, are constantly increased, which often leads to the formation of blood clots, hemorrhages, and heart attack.
• Emphysematous. This type includes COPD with prevailing dyspnea. Patients are characterized by intense breathing that exceeds the need for oxygen. Patients often complain of weakness, depression, and weight loss. There is a strong depletion of the body.

Symptoms

Chronic obstructive pulmonary disease does not appear immediately. Usually, noticeable signs are observed only 3-10 years after its onset. But even in this situation, the patient does not always go to the doctor. This behavior is especially typical for smokers. They consider coughing to be quite normal, since they inhale nicotine smoke every day. Of course, they determine the reason correctly, but they are mistaken with their further actions.

Most often, the disease is recorded in people aged 40-45 years, when the patient already feels significant shortness of breath. Therefore, it is important to know the main symptoms of COPD, especially in the initial stages:

• Cough Of all the signs, it arises first of all, having an episodic character. Then it becomes daily. In the absence of exacerbation, sputum usually does not come out.
• Sputum. Appears some time after the development of a periodic cough into a permanent one. Initially observed mainly in the morning. If the sputum becomes purulent, this indicates the development of an exacerbation.
• Dyspnea. This symptom means the transition of the disease to stage 2. Usually it is of a mixed type, less often - only with difficulty in exhaling. In the initial stages, it manifests itself only with strong physical stress, intensifying during acute respiratory infections. As it progresses, shortness of breath increases, limiting the patient's activity. In severe pathology, it develops into respiratory failure.

• If you work in a production facility and started coughing from industrial dust, then most likely you are developing.
• There is such a disease in children -. This is a hereditary pathology. We advise you to familiarize yourself.
• Rapid breathing is a clear sign. This problem, like others, can be treated with folk remedies and medicines.

Exacerbation of COPD

If the patient's condition constantly worsens for 2 or more days, this phase is called an exacerbation. In this case, the main symptoms of the disease intensify, there is an increased temperature. Depending on the severity of the pathology, the frequency of recurrence of such periods can vary within wide limits. The intervals between them are called remission phases. Exacerbation of the disease has its own characteristics of the course:

• significant increase in shortness of breath and cough;
• an increase in the volume of sputum secreted;
• frequent shallow breathing;
• high temperature;
• tachycardia;
• various neurological pathologies (for example, unmotivated agitation or depression).

Complications

At various stages of the disease, many destructive changes occur in the body, most often irreversible. Therefore, in the overwhelming majority of cases, patients have the following syndromes:

• Bronchial obstruction... It develops from the first stages of chronic obstructive pulmonary disease and gradually progresses. This process usually begins in the small bronchi. This results in increased resistance in the lower airways. Due to the deformation of the alveoli, the lung tissue loses its elasticity, pulmonary fibrosis is formed.
• Pulmonary hypertension... The main complications of COPD affect the cardiovascular system. Hypertension provokes a narrowing of the circulatory system in the respiratory organs, aggravated by thickening of the walls of blood vessels. This increases the level of pressure required for blood to flow through the network of capillaries that feed the lung.
• Pulmonary heart e. For what reasons in some patients there is an increase in the right ventricle, is still not fully known.
• Lung hyperinflation... At the same time, the lungs overflow with air and are not completely emptied when exhaling. This gradually weakens the respiratory muscles by reshaping the diaphragm. Especially this state is felt during physical exertion, not allowing to increase the depth of breathing.
• Emphysema. Since the connection of the small bronchi with the alveoli is disturbed, this negatively affects their patency.
• General intoxication of the body... In some patients, muscle weakness develops, and an inflammatory reaction syndrome is often present. All this leads to a decrease in physical activity, a general deterioration in well-being.

Diagnostics

For a correct diagnosis, it is initially necessary to determine whether a person is exposed to risk factors for developing chronic obstructive pulmonary disease. If the patient smokes, the level of possible danger caused by this habit should be calculated at all times. This will help the so-called smoker's index, calculated by the formula: (number of daily smoked cigarettes * total experience (years)) / 20. If the resulting number is more than 10, the danger of getting sick is very real. Diagnosis of COPD includes the following steps:

• Clinical and biochemical blood test... It is recommended to do it 2 times a year, as well as during periods of exacerbation.
• Sputum analysis. Determination of its macro- and microscopic properties. If necessary, conduct a study for bacteriology.
• Electrocardiogram... Since chronic obstructive pulmonary disease often causes heart complications, it is advisable to repeat this procedure 2 times a year.
• X-ray of the sternum. It must be done annually (this is at least).
• Spirometry. It allows you to determine how severe the condition of the pathologies of the respiratory system is. It is necessary to pass once a year and more often in order to adjust the course of treatment in time.
• Blood gas and pH analysis... Do at 3 and 4 degrees.
• Oxyhemometry. Evaluation of the degree of blood oxygen saturation by a non-invasive method. It is used in the exacerbation phase.
• Monitoring the ratio of fluid to salt in the body... The presence of a pathological shortage of certain microelements is determined. It is important in exacerbation.
• Differential diagnosis... Most often diff. diagnosed with lung cancer. In some cases, it is also required to exclude heart failure, tuberculosis, pneumonia.

The differential diagnosis of bronchial asthma and COPD is especially noteworthy. Although these are two separate diseases, they often occur in the same person (called overlap syndrome). The reasons and mechanisms of this are not fully understood, therefore it is necessary to know the differences in their clinical manifestations. So, starting from grade 2, patients experience shortness of breath. After the attachment of bronchial asthma, it intensifies, and as the pathologies progress, asthma attacks become more frequent. This is a rather dangerous condition that can be fatal.

The full range of laboratory tests and a thorough study of the patient's history will allow to give the correct formulation of the diagnosis of the disease. This includes the degree and severity of COPD, the presence of an exacerbation, the type of clinical presentation, and complications that have occurred.

Chronic obstructive disease treatment

It is not yet possible to completely cure chronic obstructive pulmonary disease with the help of drugs of modern medicine. Its main function is to improve the quality of life of patients and to prevent severe complications of the disease.

COPD can be treated at home. The following cases are an exception:

• therapy at home does not give any visible results or the patient's condition worsens;
• respiratory failure intensifies, developing into an attack of suffocation, heart rhythm is disturbed;
• 3 and 4 degrees in the elderly;
• complications in severe form.

In remission

To expand the bronchi, a complex of inhalations of bronchodilators is made (check the dosage with your doctor):

• M-cholinolytics: "Ipratropium bromide" ("Atrovent"), 0.4-0.6 mg or "Thiopropium bromide" ("Spiriva"), 1 capsule - effectively block M-cholinergic receptors in parasympathetic nerve endings;
• "Fenoterol" or "Salbutamol" 0.5-1 ml - drugs with pronounced bronchodilator activity.

Since the accumulation of mucus in the respiratory tract contributes to the addition of infections, mucolytic drugs are used to prevent these diseases:

• "Bromhexin", "Ambroxol" - reduce the secretory function of the respiratory system and change the composition of mucus, weakening its internal connections;
• "Trypsin", "Chymotrypsin" - medications of a protein nature, actively interacting with the accumulated secretion, reducing its viscosity and eventually leading to destruction.

With exacerbation

Treatment of chronic obstructive pulmonary disease in the acute phase involves taking glucocorticoids, more often it is "Prednisolone". With severe respiratory failure, the drug is administered intravenously. Since the systemic medicines of this group have many side effects, now in some cases they are replaced with drugs that inhibit the functions of pro-inflammatory mediators ("Fenspirid", "Erespal"). If treatment with these medications at home does not show positive results, the patient must be hospitalized.

In addition, in this phase, emphysema often progresses and mucus stagnation is formed. These conditions can lead to the development of complications, namely bronchitis or pneumonia. To prevent this from happening, antibacterial therapy is prescribed for the prevention of these diseases - penicillins, cephalosporins, fluoroquinolones.

In the elderly

For the elderly, an individual approach is required, since, due to some peculiarities, the course of the disease is most often severe. There are several factors to consider before treating them:

• age-related changes in the respiratory system;
• the presence of additional diseases associated with COPD, and their mutual influence;
• the need to take many medications;
• difficulties in diagnosis and adherence to treatment;
• psychosocial features.

Nutrition

To maintain the body in the tone necessary to resist the disease, a balanced diet is necessary:

• eating a sufficient amount of proteins (slightly more than the norm) - meat and fish dishes, dairy products;
• with a reduced body weight, you need a high-calorie diet;
• multivitamin complexes;
• reduced salt content in case of complications (pulmonary hypertension, bronchial asthma, and others).

Prevention

COPD treatment will not show positive dynamics until the patient eliminates all the factors that provoke this disease. The main recommendations are quitting smoking and timely prevention of infections affecting the respiratory system.

Effective prevention of COPD includes learning all the information about the disease, as well as knowing how to use the medical devices required during treatment. The patient should know how to properly inhale, measure the highest rate of air exit from the lungs using a peak flow meter. And, of course, you must follow all the recommendations of the doctors.

COPD is a slowly progressive disease that can worsen and even die over time. Therapy can only slow down these processes, and the adequacy of its application directly depends on how much more the patient will remain working. In some cases, periods of remission last up to several years, so such patients live for decades.

Chronic obstructive pulmonary disease (COPD) is an incurable lower airway disorder that leads to difficulty breathing. It is caused by constant inflammatory processes in the lungs, gradually leading to the degeneration of the lung tissue. It is better known as "chronic obstructive bronchitis" or "pulmonary emphysema, but according to the classification of the World Health Organization, these diseases are no longer used independently.

Definition of disease

Chronic obstructive pulmonary disease is a pathological inflammatory process in the lungs, the main consequence of which is the inability to breathe normally. The constant lack of oxygen in the body gradually leads not only to constant shortness of breath and painful coughing fits. At the same time, physical activity decreases, since in the later stages, even an attempt to climb a few steps up the stairs causes severe shortness of breath.

The insidiousness of the disease is that it can proceed without coughing, which is why it is often diagnosed late.

The main symptoms of COPD are:

1. Dry cough. In the early stages, it may not appear, which complicates the early diagnosis of the disease. But more often than not, a mild cough without phlegm is not taken seriously, which is why a person turns to a doctor too late for help.
2. Sputum. After a while, the cough becomes moist, with the coughing up of clear sputum. In the later stages, the sputum already becomes thick and abundantly secreted, often interspersed with pus.
3. Dyspnea... This symptom is caused by a lack of oxygen in the body and a chronic inflammatory process in the lungs. It manifests itself at the last stage of the development of COPD, when changes in the lung tissue become irreversible. It can manifest itself with significant physical exertion, or the weakest ARVI.

In addition, it provokes increased secretion of mucus in the bronchi, pulmonary hypertension, as well as various disorders of gas exchange, as well as hemoptysis. Chronic obstructive pulmonary disease has the following main phases:

1. First. Itself is mild, often manifested only by rare bouts of coughing. At this stage, pathological changes in the lungs are almost invisible. At this stage, the further development of the disease in some cases can be stopped if treatment is started on time.
2. Second. In the second stage, people most often begin to seek medical help. The cause is severe symptoms, such as coughing up phlegm and beginning shortness of breath. Pathological changes in the lungs become irreversible. After that, treatment can only be directed to inhibiting painful symptoms.
3. Third... At the third, rather difficult stage, the volume of air entering the lungs sharply decreases. This is due to the development of obstructive phenomena characterized by severe shortness of breath and bouts of coughing with purulent sputum;
4. Fourth. The most severe stage, leading to complete disability, and often posing a threat to life. It is at this stage that a pathology such as cor pulmonale appears, and respiratory failure appears.

The development of chronic obstructive pulmonary disease is provoked by such basic factors as:

• Long-term smoking;
• Polluted air in the home (for example, from the use of solid fuel for heating);
• Low socio-economic status of a person or his family;
• Chronic infectious diseases of the lower respiratory tract (or);
• Adenovirus infection;
• Deficiency of vitamin C in the body;
• Conditions of professional activity associated with the presence of dust and vapors of chemicals (varnishes, paints, gases) in the air.

Another common cause of the development of COPD is the so-called "passive smoking". That is why health problems arise not only for the smoker himself, but also for all members of his family.This is especially dangerous for children, as it increases the risk of developing COPD in the future.

Correct and timely treatment of lower respiratory tract diseases during childhood helps prevent the development of COPD in adulthood.

General principles of prescribing drug therapy

Diagnosing chronic obstructive pulmonary disease is very simple. To do this, it is enough to conduct spirometry and determine the volume of inhaled air. Once this diagnosis has been made, complete recovery is impossible. At the same time, a competently conducted complex therapy aimed at strengthening the immune system and reducing symptoms.

COPD treatment can only be carried out with the help of medication tolerance and under the constant supervision of the attending physician. Self-medication in this case can lead to serious consequences, up to a threat to life.

Complex drug therapy for COPD is aimed at:

• The need to prevent further development of the disease;
• Reducing the development of painful symptoms;
• The ability to prevent the development of complications;
• Prevention of complications.

Correct drug therapy can prevent the development of all these problems and, if possible, improve the quality of life. What are the symptoms of influenza and ARVI, the differences between them are described in.

It is worth remembering that even the most modern and high-quality therapy cannot completely restore the affected tissue.

COPD treatment with drugs (list of drugs)

The basis of drug treatment is various drugs that help expand the bronchi and relax their muscles. First of all, these are drugs from the group of bronchodilators (bronchodilators). At each stage of the development of the disease, their own groups of medications are used, the volume of which is increasing.

All pharmacological agents used in the treatment of COPD are subdivided into those used in outpatient treatment and in a hospital setting.

At the first stage (bronchodilators and inhalation)

At the initial stage of the development of the disease, the doctor prescribes drugs from the group of bronchodilators. Depending on the severity of the disease, they can be used constantly or on demand, during an exacerbation. For this, the following list of drugs is used:

• Anticholinergics;
• β2-adrenergic agonists;
• Theophylline.

Most often, they are prescribed in a course of 10-14 days during an exacerbation. In COPD, the preferred method of drug management is inhalation, with the use of modern.

Antibacterial drugs are used exclusively for infectious exacerbations of the disease.

Additionally, antioxidants with mucolytic effect are used. Most often, a drug such as N-acetylcysteine \u200b\u200bis used for this, used in a dosage of 600 milligrams per day. It can be used for a long time, from 3 to 6 months, on an outpatient basis.

Bronchodilator drugs for the second

At more severe stages, the main drugs are long-acting bronchodilators used by inhalation. Most often, these are quite expensive drugs, most often used in hospital treatment. These can be combination drugs such as:

• Salbutamol (100/200 mgk, 2 inhalations 2 times a day);
• Budesonideor Formoterol (160 / 4.5 mcg, 2 inhalations are applied 2 times a day);
• Salmeterol (50 mcg, 1 inhalation 2 times a day).

They can be used both in a hospital setting and on an outpatient basis, under the constant supervision of a doctor. At this stage, mucolytic drugs such as carbocisteine \u200b\u200bor various iodine preparations are used to facilitate the coughing of sputum.

On third

Long-acting bronchodilators in combination with glucocorticosteroids also remain the mainstay of treatment. Treatment of COPD at this stage should be carried out. These drugs have a pronounced anti-inflammatory effect, therefore they are even more effective than in bronchial asthma. For this, drugs such as Fluticasone propionate at a dosage of 1000 mcg / day can be used.

In a severe stage, drug treatment should be combined with oxygen therapy, or oxygen therapy.

The need for surgical intervention

At the most severe, or fourth stage of the development of COPD, medical treatment of the disease is no longer enough. At this stage, a decision is often made about the need for surgical treatment. This helps to at least slightly improve lung function and reduce painful symptoms when drug treatments no longer give the desired result.

The decision on the need for surgical treatment has not been studied enough. Therefore, it is used only in case of a threat to life.

In the case of severe emphysema of the lungs with severe shortness of breath, purulent sputum and hemoptysis, they resort to bulloectomy. This operation reduces shortness of breath and improves lung function. In addition, surgical methods are used such as:

• Pulmonary volume reduction surgery (reduces shortness of breath during the slightest physical exertion, for example, when dressing or trying to walk a few meters);
• Lung transplant (a radical method of treatment that allows a patient with COPD to return to an almost full life).

After surgical treatment, a period of rehabilitation begins, during which the person enters the stage of stable remission and returns to everyday life. It includes spa treatment, as well as physical and social adaptation to a fulfilling life.

Chronic obstructive pulmonary disease is most often incurable, but with the correct algorithm of actions, you can live almost fully. This allows you to reduce the frequency of exacerbations and prolong periods of persistent rehabilitation. For this, the patient is advised to follow these recommendations:

1. Visit your doctor regularly and strictly follow his instructions;
2. Observe the daily routine, sleep at least 8 hours;
3. Avoid unnecessary physical and emotional stress.

As with most pulmonary diseases, a complete and balanced diet rich in vitamins and minerals is of great importance.

One of the important components of the lifestyle with COPD is a high-calorie diet, and strictly dosed physical activity.

A serious illness like COPD is easier to prevent than very long and difficult to treat. includes:

1. Complete smoking cessation;
2. and pneumococcal infection;
3. Timely treatment of infectious diseases of the respiratory tract;
4. An active lifestyle that includes regular physical activity.

You should also avoid working in hazardous industries, if necessary, use personal protective equipment.

Video

This video will tell you about the treatment of COPD.

conclusions

The most common cause of COPD is long-term smoking or frequent infections of the lower respiratory tract. Long-term persistent irritation of bronchial tissues by chemical or mechanical irritants leads to a constant inflammatory reaction of the lungs. A particular danger is that the disease can develop slowly and almost asymptomatically. With timely prevention, or started as early as possible drug treatment, the disease can be prevented. Find out about the treatment of a smoker at.