Celli B R
St. Elizabeth's Medical Center, Boston, Massachusetts, USA.
Respir Care Clin N Am. 1998 Sep;4(3):359-70, vii.
The prevalence of COPD has increased as mortality from the two organ systems affected by the same risk factors of smoking, heart attacks and strokes, has decreased. Once diagnosed, COPD is progressive and may lead to disability, usually due to dyspnea, at a relatively early age (60 to 80 years of age). COPD is usually caused by destruction of the lung parenchyma or by disease affecting the airways. In most patients both processes exist simultaneously. Less often recognized is the fact that the disease does not affect all portions of the lung alike, which causes different physiologic behaviors in different parts of the lung. This article integrates the pathologic changes of COPD with the known adaptive and maladaptive consequences of those changes. An understanding of these changes should result in an increased capacity to comprehend the different therapeutic strategies that have been developed to decrease the symptoms and improve the well-being of patients with COPD.
随着受吸烟、心脏病发作和中风等相同风险因素影响的两个器官系统的死亡率下降，慢性阻塞性肺疾病（COPD）的患病率却有所上升。一旦确诊，COPD呈进行性发展，通常在相对较早的年龄（60至80岁）就可能导致残疾，这通常是由呼吸困难引起的。COPD通常是由肺实质破坏或影响气道的疾病所致。在大多数患者中，这两种情况同时存在。较少被认识到的是，该疾病对肺的各个部分影响并不相同，这导致肺的不同部位出现不同的生理表现。本文将COPD的病理变化与这些变化已知的适应性和适应不良后果相结合。了解这些变化应有助于增强理解为减轻COPD患者症状和改善其健康状况而制定的不同治疗策略的能力。
