Hobl is diagnosed. COPD Diagnosis: Causes, Symptoms, Diagnosis and Treatment

1980 03.10.2019 5 min.

In our country, approximately one million people have chronic obstructive pulmonary disease. But it is possible that this figure is much higher.

The main cause of COPD is smoking. It doesn't matter if it's passive or active.

This lung disease is characterized by the progression and gradual loss of lung function. In this article, we will talk about the complications of COPD, as well as preventive methods that will prevent the development of this disease.

COPD - the definition of the disease

According to statistics, they are more likely to get sick men after forty years. Chronic illness lung disease is one of the causes of disability and ranks fourth among the causes of death among the working population.

There are four stages depending on the forced expiratory volume and forced vital capacity of the lungs:

Zero stage (stage of predisease). It is characterized by an increased risk of developing chronic obstructive pulmonary disease, but may not always pass into it. Signs: persistent cough with phlegm, but the lungs are still functioning.
The first stage (the stage of light flow). You can detect minor obstructive disorders, there is a chronic cough with sputum.
The second stage (the stage of moderate course). There is a progression of disorders.
The third stage (the stage of severe course). When exhaling, there is an increase in airflow limitation.
The fourth stage (the stage of extremely severe course). Manifested by a severe form of bronchial obstruction, there is a threat to life.

COPD development mechanism: tobacco smoke or another negative factor affects the vagus nerve receptors, which causes bronchospasm, stops the movement of their ciliated epithelium. Therefore, bronchial mucus cannot come out naturally, and its cells begin to produce even more mucus (defensive reaction). This is how chronic cough occurs. Many smokers think that nothing serious will happen, and they cough because of smoking.

But after a while, a chronic focus of inflammation develops, which clogs the bronchi even more. As a result of this, the alveoli are overstretched, which compress the small bronchioles, further disrupting the patency.

It should be remembered that at the beginning of the disease, the blockage is still reversible, since it occurs due to bronchospasm and mucus hypersecretion.

Therapy of the disease is aimed primarily at slowing down the progression of obstruction and the development of respiratory failure. Treatment helps to reduce the likelihood of exacerbations, and also makes them less severe and longer. Treatment helps to increase vital activity and increases. It is very important to eliminate the cause of the development of the disease.

Causes and treatment during an exacerbation

Nine out of ten cases of COPD are caused by smoking. Other factors affecting the development of the disease to a lesser extent include harmful production conditions (for example, inhalation of harmful gases), respiratory diseases transferred to childhood, bronchopulmonary pathologies, poor ecology.

The main occupational hazards are working with cadmium and silicon, metal processing, and fuel combustion products also affect the development of COPD. Therefore, chronic obstructive pulmonary disease occurs in miners, railway workers, builders, workers in the pulp and paper and metallurgical industries, and agricultural workers.

Very rarely, people have a genetic predisposition to COPD. In this case, there is a lack of alpha-1-antitrypsin protein, which is produced by liver tissue. It is this protein that protects the lungs from damage by the enzyme elastase.

All of the above causes cause a chronic inflammatory lesion of the inner lining of the bronchi, resulting in impaired local bronchial immunity. There is a production of bronchial mucus, it becomes more viscous. Because of this, they create good conditions to activate pathogenic bacteria, bronchial obstruction occurs, lung tissues and alveoli change. As a person's condition worsens with COPD, swelling of the bronchial mucosa develops, smooth muscles spasm, a lot of mucus is produced, and the number of irreversible changes increases.

Symptoms and methods of diagnosis

At the initial stage of the disease, a periodic cough occurs. But the farther, the more often he worries (even at night).

When coughing, a small amount of sputum is secreted, the volume of which increases with exacerbation. Sometimes it may contain pus.

Another symptom of chronic obstructive pulmonary disease is shortness of breath. It can appear very late, even after a decade.

Patients with COPD are divided into two groups:

"Pink Puffers". These people are generally thin in build and suffer from shortness of breath, causing them to puff and puff out their cheeks. The skin becomes pink-gray.
"Bluish puffers". Usually these are overweight people. They suffer from a strong cough with phlegm, as well as swelling of the legs. Their skin has a blue tint.

The first group of patients has an emphysematous type of COPD. In this case, the main symptom is expiratory dyspnea (difficulty exhaling). Emphysema prevails over bronchial obstruction.

The second group has purulent inflammatory processes occurring in the bronchi and accompanied by symptoms of intoxication, cough with copious sputum (bronchitis type COPD). Bronchial obstruction is more pronounced than pulmonary emphysema.

Complications

Because COPD progresses over time, complications are sometimes unavoidable. But you can reduce the risk of their occurrence. To do this, sometimes you just need to quit smoking, avoid inhaling tobacco smoke and other chemicals.

If the symptoms of COPD suddenly worsen, then they speak of an exacerbation of the disease. Exacerbation can be caused by infection, pollution environment etc. It can occur up to several times a year.

Complications of chronic obstructive pulmonary disease include:

Respiratory failure.
Pneumothorax (air entering the pleural cavity).
(pneumonia). May be caused by bacteria. Streptococcal pneumonia is considered the most common cause of bacterial pneumonia in COPD.
Blockage of blood vessels (thromboembolism).
Deformation of the bronchi (bronchiectasis).
Pulmonary hypertension ( high pressure v pulmonary artery).
Pulmonary heart (thickening and expansion of the right parts of the heart with dysfunction).
Lungs' cancer.
Chronic heart failure, stroke.
Atrial fibrillation (heart rhythm disorder).
Depression. Emotional disorders may be associated with a decrease in the activity of life in general.

Prevention

The main direction of prevention of chronic obstructive pulmonary disease is smoking cessation. You need to lead a healthy lifestyle, eat right and balanced, and also strengthen the immune system.

Physical activity should include walking at a moderate pace, swimming in the pool and breathing exercises that strengthen the respiratory muscles.

Do not forget about the timely treatment of any infectious diseases respiratory tract.

Those whose work involves exposure to hazardous substances should be aware of safety precautions and the use of individual means protection.

COPD needs to be treated at an early stage. And in order to detect the problem in time, it is recommended to undergo a medical examination.

Unfortunately, the progression of COPD can lead to disability of the patient. An unfavorable outcome is possible with severe concomitant diseases, heart and respiratory failure, advanced age, bronchitis type of the disease.

Video

conclusions

It is a progressive disease. It cannot be completely cured in the later stages, so patients should lead a proper lifestyle, control symptoms, which can slow down the development of chronic obstruction.

COPD is dangerous for its complications. To prevent their occurrence, proper treatment is necessary, the purpose of which is to slow down all progressive processes in the lungs, remove obstructions and exclude respiratory failure.

Chronic obstructive pulmonary disease is a chronic non-allergic inflammatory disease respiratory system due to irritation of the lungs by toxic substances. The abbreviated name of the disease - COPD, is an abbreviation made up of the first letters of the full name. The disease affects the final sections of the respiratory tract - the bronchi, as well as the respiratory tissue - the lung parenchyma.

COPD is the result of exposure to harmful dust and gases on the human respiratory system. The main symptoms of COPD are cough and shortness of breath during exercise. Over time, the disease progresses steadily, and the severity of its symptoms increases.

The main mechanisms of painful changes in the lungs in COPD:

development of emphysema - swelling of the lungs with rupture of the walls of the respiratory vesicles-alveoli;
the formation of irreversible bronchial obstruction - difficulties for the passage of air through the bronchi due to the thickening of their walls;
a steady increase in chronic respiratory failure.

About the causes of COPD and its dangers

Inhalation of tobacco smoke, toxic gases and dust causes inflammation in the airways. This chronic inflammation destroys the respiratory tissue of the lungs, forms emphysema, violates the natural protective and regenerative mechanisms, causes fibrous degeneration of the small bronchi. As a result, it breaks right job respiratory system, the air is retained in the lungs, the speed of the air flow in the bronchi progressively decreases. These internal disturbances cause the patient to experience shortness of breath on exertion and other symptoms of COPD.

Smoking is the main causative factor in COPD. According to statistics, every 3rd resident smokes in Russia. In this way, total strength smoking Russians is about 55 million people. In absolute numbers by the number of smokers the Russian Federation ranks 4th in the world.

Smoking is both a risk factor for COPD and cardiovascular disease.

Experts predict that by 2020 smoking will kill 20 people per minute. WHO estimates that smoking is responsible for 25% of deaths in patients with ischemic disease heart and 75% of deaths of patients chronic bronchitis and COPD.

The combined effect on the lungs of tobacco smoking and harmful industrial aerosols is a particularly deadly combination. People with this combination of risk factors develop the most severe form of the disease, rapidly leading to irreversible lung damage and death from respiratory failure.

COPD is one of the leading causes of morbidity and mortality worldwide, which leads to significant, ever-increasing economic and social damage to society.

What signs will help to suspect COPD?

The presence of COPD should be suspected in people with persistent cough, shortness of breath, sputum production, with past or present exposure to risk factors. These symptoms alone are not diagnostic, but the combination of them greatly increases the likelihood of a diagnosis of COPD being made.

Chronic cough is often the 1st symptom of COPD and is underestimated by the patient himself. People consider these coughs to be a natural consequence of smoking or exposure to other harmful air pollutants. At first, the cough may be intermittent, but over time it becomes daily, constant. In COPD, chronic cough may be without sputum (unproductive).

Shortness of breath on exertion is the main symptom of COPD. Patients describe shortness of breath as a feeling of heaviness in the chest, suffocation, lack of air, the need to make efforts to breathe.

Typically, people with COPD cough up a small amount of sticky sputum after a coughing episode. The purulent nature of sputum indicates an exacerbation of inflammation in the airways. A persistent cough with phlegm can bother a person for several years before the onset of shortness of breath (before the start of airflow limitation). However, a decrease in airflow rate in COPD can develop without chronic cough and sputum production.

As the disease progresses, complaints of general weakness, constant malaise, bad mood, increased irritability, and weight loss may appear.

What does an examination reveal in a COPD patient?

In the initial period of the disease, the examination does not reveal any abnormalities characteristic of COPD. Over time, with an increase in bloating and an irreversible violation of bronchial patency, a barrel-shaped deformation of the chest appears - a characteristic expansion of it in anterior-posterior size. The appearance and severity of deformity depend on the degree of swelling of the lungs.

Widely known are 2 types of COPD patients - "pink puffers" and "blue puffers". In a number of patients, symptoms of pulmonary distention come to the fore, and in others, airway obstruction. But those and others have both signs.

In severe forms of the disease, there may be a loss muscle mass which leads to weight loss. In obese patients, despite the increased weight, one can also notice a decrease in muscle mass.

Prolonged intense work of the respiratory muscles leads to its fatigue, which is further aggravated by malnutrition. A sign of fatigue of the main respiratory muscle (diaphragm) is the paradoxical movement of the anterior wall of the abdominal cavity - its retraction during inspiration.

Cyanosis (cyanosis) of the skin of a gray-ashy hue indicates a severe lack of oxygen in the blood and a severe degree of respiratory failure. It is important to determine the level of consciousness. Lethargy, drowsiness, despite severe shortness of breath, or, conversely, the excitement accompanying it, indicate oxygen starvation, life-threatening, which requires emergency care.

Symptoms of COPD on external examination

An external examination of the lungs in the initial period of the disease carries scarce information. When percussion of the chest, a box sound may appear. When listening to the patient's lungs during an exacerbation, dry whistling or buzzing rales appear.

In the clinically significant stage of COPD, external examination data reflect severe pulmonary emphysema and severe bronchial obstruction. The doctor finds during the study: boxed sound when percussion, limitation of diaphragm mobility, chest rigidity, weakening of breathing, wheezing or buzzing scattered wheezing. The predominance of one or another sound phenomenon depends on the type of disease.

Instrumental and laboratory diagnostics

The diagnosis of COPD must be confirmed with spirometry, a lung function test. Spirometry in COPD detects bronchial airflow limitation. characteristic feature disease is the irreversibility of bronchial obstruction, that is, the bronchi practically do not expand when inhaled with a standard dose of a bronchodilator drug (400 μg of salbutamol).

Radiation diagnostic methods (X-ray, CT) are used to exclude other severe lung diseases that have similar symptoms.

At clinical signs severe respiratory failure, it is necessary to assess the levels of oxygen and carbon dioxide in arterial blood. If this analysis is not possible, a pulse oximeter that measures saturation can help assess the lack of oxygen. When blood saturation is less than 90%, immediate administration of oxygen inhalation is indicated.

Principles of COPD treatment

Key points in the treatment of patients with COPD:

smoking patients need to stop smoking, otherwise taking medication loses its meaning;
smoking cessation is facilitated by nicotine replacement drugs (chewing gum, inhaler, nasal spray, skin patch, sublingual tablets, lozenges);
to reduce shortness of breath and swelling of the lungs, drugs are used that expand the bronchi for 12-24 hours (long-acting bronchodilators) in inhalations;
to reduce the severity of inflammation with frequent exacerbations, roflumilast is prescribed - new drug for the treatment of COPD;
patients with decreased oxygen saturation in the blood<90%, показана длительная кислородотерапия >15 hours a day;
for patients with a low inhalation rate, inhalation of drugs can be carried out using a nebulizer - a special compressor inhaler;
exacerbation of the disease with expectoration of purulent sputum is treated with antibiotics and expectorants;
all patients with COPD are shown classes in the pulmonary rehabilitation program, including smoking cessation, education, feasible physical training, nutritional counseling and social support;
to prevent infectious exacerbations, COPD patients are recommended annual influenza vaccination, as well as vaccination against pneumococcus.

COPD prevention

most effective prevention COPD would be a worldwide ban on the production, sale and smoking of tobacco and tobacco products. But while the world is ruled by capital and greed, this can only be dreamed of.

The drowning will have to take their salvation into their own hands:

to prevent the development of COPD in a smoker, you need to part with cigarettes (cigarettes, tobacco, etc.);
to prevent the development of COPD in a non-smoker, he does not need to start smoking;
to prevent the development of COPD in workers in hazardous industries, it is necessary to strictly observe safety precautions and the maximum allowable periods of continuous work in this industry.

To prevent COPD in your children and grandchildren, set an example of a healthy lifestyle and zero tolerance for smoking.

Among the pathologies that affect the organs of the respiratory system, obstructive lesions stand apart, due to the specifics clinical manifestations. For this reason, these diseases are not well known, and patients are often frightened, and rightly so, when they are diagnosed with COPD. What is it and how is it treated, our experts will tell.

Under the obscure abbreviation COPD is 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 COPD code set for ICD 10 means that according to International classification 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 damage is for health, it is not necessary to delve into the underlying processes that occur 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 tissues 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 the secretion naturally. For bacteria, such stagnation is the best stimulant for development and reproduction.

Due to bacterial activity, the patency of the bronchial communications that connect 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;
increasing the viscosity of the secretion.

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

Provoking factors

Harmful factors are the basis for the occurrence of COPD. One of the main factors causing irreversible lung obstruction is smoking. In vain do 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 more than one day, and not even a year - most often, a disappointing diagnosis is made to those who are over 40.

Passive smokers are also at risk.

Inhalation of tobacco smoke not only irritates the respiratory mucosa, but also gradually destroys their tissues. Loss of elasticity of the alveolar fibers 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 for COPD:

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

The emergence and development of COPD is not associated with the course of other chronic processes in the organs of the respiratory system. But it refers to a number of occupational pathologies that affect metallurgists, builders, miners, railway workers, workers of pulp and processing enterprises, as well as agricultural workers involved in the processing of grain and cotton.

In terms of the number of deaths, COPD ranks fourth among the main pathologies of the working population.

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 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:

light. Functionality of external respiration corresponds to the norm. The ratio between FEV1 and FVC is less than 70% of the norm, which is regarded as a sign early development bronchial obstruction. Chronic symptoms may not be observed;
average. Indicators of the functions of external respiration are less than 80%. The ratio between FEV1 and FVC is less than 70% of the norm, which confirms the progress of obstruction. The cough gets worse. There are other characteristic symptoms of the disease;
heavy. OVF1 indicators are less than 50% of the norm. The ratio of FEV1 and FVC is less than 70% of the norm. Accompanied by a strong cough, copious sputum and significant shortness of breath. There are attacks of exacerbations;
extremely heavy. The functionality of external respiration is provided by less than 30%. It is characterized by the appearance of respiratory failure and the development of cor pulmonale with an 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 thing a healthy person can and should do is to prevent the occurrence of disease by making efforts to ensure preventive measures.

Symptoms of chronic obstructive pulmonary disease

The characteristic signs of the development of COPD appear at the stage moderate currents. Before the onset of the later stages, the disease proceeds in a latent form and may be accompanied by a small episodically appearing cough. As the pathology develops, the secretion of mucous sputum joins the cough.

Approximately ten years after the onset of early symptoms, shortness of breath develops - a feeling of lack of air accompanies physical activity. Over the years, the intensity of shortness of breath increases. In severe COPD, shortness of breath causes a 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 the pathology reaches a severe phase:

coughing fits become long 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 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 expression of the symptoms of the disease and their characteristics, there are two clinical forms of COPD - bronchial and emphysema.

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

predominance of cough, shortness of breath;
severity of bronchial obstruction;
the severity of hyperventilation of the lungs - weak or strong;
the color of cyanosis is blue or pinkish gray;
the period of formation of the cor pulmonale;
the presence of polycythemia;
severity of cachexia;
age at which it is possible fatal outcome.

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

Treatment of chronic obstructive disease:

Due to the fact that timely diagnosis is not possible, COPD treatment is most often started at the onset of the moderate or severe stage. The collection of anamnesis provides for the identification of individual risk factors - the determination of the smoker's index, the presence of infections.

For differential diagnosis With bronchial asthma study the parameters that characterize shortness of breath when exposed to a provocative stimulus.

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

As additional diagnostic measures apply:

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

Only after the diagnosis has been clarified and the stage and form of the disease determined, treatment is prescribed.

In remission

During periods of decline in acute manifestations of COPD, patients are recommended to use bronchodilators that increase the lumen of the bronchi, mucolytics that thin sputum, as well as 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

The treatment of COPD in the elderly is not only about the use drug therapy, but also using folk remedies, providing aerobic exercise and preventive measures, including quitting smoking and correcting respiratory failure.

Alternative methods and means of treating COPD

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

mitigation of symptoms;
slow pathological progress;
launch of regeneration mechanisms;
restoration of vitality of the patient.

Most effective way effects on tissues affected by COPD are considered to be inhalations based on plant materials - oregano, mint, calendula, chamomile, as well as essential oils of pine and eucalyptus.

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

Breathing exercises

Aerobic exercise and a set of breathing exercises form the basis for the rehabilitation of patients with COPD. Thanks to respiratory gymnastics, the weakened intercostal muscles are included in the breathing process, the smooth muscles of the lungs are strengthened, and at the same time, the psychological condition sick.

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

Exercise is allowed only during the remission period.

COPD prevention

Smoking cessation is considered the basis of COPD prevention, 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 in hazardous work;
respiratory protection from contact with substances hazardous to health;
strengthening immunity - physical activity, hardening, compliance with the regime of the day;
healthy food.

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

COPD, the symptoms of which significantly impair the quality and duration of life of patients, is a serious pathology of the human respiratory system. The basis of the disease is a partial restriction of air supply to Airways person. The changes are irreversible and tend to progress.

Development of chronic obstructive pulmonary disease

The main reason for the development of pathology in adults is nicotine addiction. The disease can occur against the background of:

Hazards in production (constant inhalation of gases). Obstructive pulmonary pathology is a standard disease for miners, agricultural workers, and railway workers. The disease occurs during prolonged work with silicon, cotton, grain, elements of the pulp and paper and metallurgical industries.
Frequent and prolonged respiratory disorders in childhood.
Environmental pollution. Dirt, exhaust gases increase the secretion of viscous mucus, disrupting the airway.
genetic predisposition. A sign is the insufficiency of alpha-1-antitrypsin, which is responsible for protecting the lung mucosa from the negative effects of the environment. Its insufficiency is fraught with susceptibility of the lungs to all kinds of pathologies.

Over time, COPD irreversibly changes the airways: peribronchial fibrosis develops, emphysema is possible. Respiratory failure is increasing, bacterial complications are added. Against the background of obstruction, gas exchange is disturbed (the O2 index decreases, CO2 in the arterial blood increases), cor pulmonale(cause of poor circulation, mortality of patients).

Stages of lung obstruction

Experts distinguish 4 stages of COPD. The distribution by stages is based on the decrease in the ratio of FEV1 (forced expiratory volume in the first second) to FVC (forced vital capacity) - the so-called Tiffno test. Pathology is evidenced by a decrease in this indicator of less than 70% against the background of taking bronchodilator drugs. Each stage of COPD is characterized by certain symptoms:

Stage 0 - premorbid condition. This is a period of increased risk of developing pathology. It begins with a cough, which is transformed into a permanent one, while the secretion of sputum increases. Lung function does not change. Timely treatment at this stage prevents the further development of the disease.
Stage 1 - mild COPD. Chronic cough and sputum production remain, minor obstructive disorders appear (FEV1 is more than 80%).
Stage 2 - moderate pathology. Significantly increased obstructive disorders (FEV1 less than 80%, but more than 50%). Shortness of breath, palpitations, weakness, dizziness develop.
Stage 3 - a severe form of pathology. Significant obstructive disorders (FEV1 less than 50%, but more than 30%). Shortness of breath and exacerbations intensify. These symptoms are observed even at rest.
Stage 4 is a very severe form of COPD. The extreme degree of bronchial obstruction, which is life threatening (FEV1 less than 30%) of the patient. There are signs of significant respiratory failure, possibly cor pulmonale.

Clinical forms of the disease

Symptoms of COPD develop in stage 2 of the disease. Deciphering the disease early stages practically impossible, as it often proceeds secretly. Main symptoms: cough with sputum, shortness of breath. Initially, episodic cough, mucous sputum. Shortness of breath appears against the background of strong physical exertion. Then the cough becomes constant, the amount of sputum increases (it becomes viscous, purulent). Shortness of breath worries patients constantly.

Accession of infection is fraught with aggravation of the patient's condition: the body temperature rises, the amount of sputum increases, a wet cough appears. Obstruction can develop in two clinical forms:

bronchitis type. Symptoms are associated with purulent inflammation of the bronchi. The patient has the following symptoms: significant intoxication, cough, copious purulent sputum. In the first place - a significant bronchial obstruction, and pulmonary emphysema is weakly expressed. Symptoms and treatment of the disease depend on the age of the patient. Bronchitis type COPD can lead to the development of serious complications. At the terminal stage of obstruction, patients have "blue edema".
With the development of the emphysematous type of COPD, patients complain of expiratory shortness of breath (expiration is difficult). Emphysematous changes in the lungs come to the fore, and not obstructive manifestations. Patients acquire a pinkish-gray color of the skin, cachectic exhaustion is observed. When diagnosing, the doctor notes chest barrel-shaped, so patients with this diagnosis are called "pink puffers." This form of the disease is much more favorable than the previous one. It has a slow progression. She has a favorable prognosis.

COPD can be made worse by:

pneumonia;
respiratory failure (acute and chronic);
erythrocytosis (secondary polycythemia);
congestive heart failure;
pulmonary hypertension and cor pulmonale.

Diagnostic methods

Pathology slowly but surely progresses, damaging the human airways. This requires timely and accurate diagnosis of the body. To make a diagnosis of COPD, a doctor will:

Collecting an anamnesis with the obligatory specification of the presence bad habits and occupational risk factors.
Spirometry is the "gold standard" for diagnosing COPD. Evaluate speed and volume indicators. Among them: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1). Indicators are analyzed before and after taking bronchodilators to assess the degree of reversibility of obstruction.
Sputum cytology. This study is carried out in order to determine the nature, severity of bronchial inflammation, to exclude oncopathology. Viscous, purulent sputum with a large number of bronchial epithelial cells and leukocytes indicates an exacerbation of the pathology, and the presence of a large number of macrophages of a mucous nature indicates remission of obstruction.
Clinical and biochemical blood tests. Deciphering a blood test with obstruction indicates polycythemia (an increase in all blood cells), and increased viscosity is the result of the development of oxygen deficiency. To confirm hypoxemia, the gas composition of the blood is studied.
X-ray examination. It is carried out for differential diagnosis with other pathologies, but with a similar clinic. In COPD, radiographs show seals, deformations of the walls of the bronchi, changes in the lungs of an emphysematous nature.
ECG. Hypertrophic changes are revealed in the right parts of the heart, blockade of the legs of His is possible, an increase in the T wave.
Bronchoscopy. It is carried out for the differential diagnosis of pathology. The doctor examines and evaluates the condition of the mucosa in an adult patient, takes the secret of the bronchi for analysis. By bronchoscopy, you can inject the drug into the lesion.

The purpose of a comprehensive and methodical examination of the patient is to establish a correct and timely diagnosis.

This will slow down the development of respiratory failure, reduce the frequency of exacerbations, and significantly improve the duration and quality of life.

Video about the diagnosis and treatment of COPD:

Forecast and prevention

The prognosis of pathology is unfavorable. With the progression of obstruction, the patient's performance decreases, disability may occur. To reduce the frequency and severity of exacerbations, it is recommended:

eliminate the provoking factor;
strictly follow all the recommendations of the doctor;
saturate the body with vitamins, minerals and healthy food.

Video about symptoms and treatment of COPD:

To prevent the development of obstructive pathologies, it is necessary to stop smoking, follow the rules of labor protection in production, treat respiratory pathologies in a timely manner, and prevent exacerbations of COPD.

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) hides a dangerous disease that cannot be completely cured if you miss the beginning of its development. V modern world it ranks third in the number of deaths after cardiovascular and oncological diseases. In European countries, for every 100,000 people, there are up to 40 deaths from COPD per year.

The main causes of the disease

The risk factors for COPD are different. Critical for health are:

years of active smoking
harmfulness in production
unfavorable environment.

Smokers make up the majority of the risk group for COPD. main reason covered in tobacco smoke. A huge amount (more than 500) of harmful components found in tobacco, when inhaled, causes irritation of the bronchial mucosa. Long-term negative exposure to them causes inflammation, eventually developing COPD. Not only smokers themselves suffer, but also household members (including children) and non-smoking colleagues: passive smoking can also lead to this disease.

The occurrence of COPD may also be due to occupational factors contributing to the development of the disease. They can be inhalation of toxic fumes, work in a dusty environment, contact with harmful metals.(for example, with cadmium or silicon). The occupational risk group includes workers in the chemical industry, construction specialties, road workers, miners.

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

Signs of COPD

Shortness of breath and cough with sputum are early symptoms of the disease. Cough usually excruciates 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.
It is quite natural to feel short of breath after strenuous exercise. But if she is worried as a result of the most common actions, then it is necessary 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.

Mild, COPD grade 1 is rapid breathing during brisk walking or when climbing a small height.
Moderate severity, COPD of the 2nd degree - a sick person has difficulty walking fast, he is forced to walk slowly even on a flat surface. Based on the general condition of the patient, it is possible that disability will be issued for COPD group III of this degree.
Severe, COPD of the 3rd degree - the patient begins to suffocate after minutes of walking on a flat surface. Members of the commission will give the II or III disability group (the disability group will depend on his general condition).
Very severe shortness of breath, COPD 4th degree - the patient suffocates even during normal activities or going outside, cannot serve himself. Gradually, his condition becomes worse, complications arise. With COPD of this degree, the first group of disability is issued.

With 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 to work, whether he has been transferred to a lower-paid position, whether he can serve himself and, if necessary, provide emergency assistance to himself.

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

Complications

Complications of COPD are as dangerous as the disease itself. Like any chronic inflammation, this disease has a negative effect on body 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

With COPD, life expectancy depends entirely on whether the severity of the disease is correctly determined and whether treatment is started in a timely manner. 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 patients go to the doctor with a complaint of a wet cough. After all, smoker's bronchitis is the norm for long-term smoking, as smokers themselves believe.

If there is no appropriate medical care, then the prognosis for the course of the disease is disappointing: the disease will only progress, this will certainly lead the patient to disability. But thanks proper treatment stabilization of the course of the disease can be achieved. Such people can live a long life.

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

How and what to treat the disease

Prevention of COPD, like any disease, is in the first place in its treatment.

It involves following the rules:

Most importantly, it is urgently and permanently necessary to get rid of smoking, otherwise any treatment for COPD will not be effective.
The use of a respirator for respiratory protection, reducing the number of harmful factors in the workplace. If it is impossible to fulfill these conditions, it is necessary to change the place of work.
A complete and healthy diet with enough protein and vitamins.
Regular breathing exercises, swimming, walking - at least 20 minutes a day.

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

Treatment with drugs

The goal of drug treatment is to reduce the frequency of exacerbations (it is during exacerbations that most patients die) and to prevent complications. 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.

Main 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 side effects. But you can not allow an overdose, you must strictly follow the recommendations in the instructions. It is recommended to control the heart rate (HR): it should be no more than 90 beats per minute. Bronchodilators are used in most cases in the form of inhalations.
Glucocorticosteroids (GCS) are used to treat severe disease or exacerbations ( prednisone, budesonide). In severe respiratory failure, glucocorticosteroids are administered by injection to relieve attacks.

Mucolytics are taken to thin sputum and facilitate its excretion ( carbocysteine, ambroxol, bromhexine, ACC). Used only in case of 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 during exacerbation of the disease - in the form of tablets, injections, inhalations.
Antioxidants reduce the duration and severity of exacerbations, but are used for 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 working capacity, improves the functioning of the lungs. But the downside of this operation is its high cost and the problem of finding a donor.

Oxygen therapy

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

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

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

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

Other methods of respiratory therapy

Percussion drainage is a fairly new technique. It is based on the supply of small portions of air into the bronchi under the required pressure and at a set frequency. The patient immediately feels relieved breathing.

Breathing exercises according to the Strelnikova method, inflating balloons, exhaling through the mouth through a tube dipped into water, will serve as a useful addition to medicines.

V rehabilitation centers assistance is provided to all patients with COPD, starting from 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 apply for medical care or provide it yourself.

Folk remedies for the treatment of COPD

Treatment of COPD with medicinal preparations is recommended to be carried out in conjunction with medications. Otherwise a good result from the application of recipes traditional medicine not worth the wait. The following are simple yet effective folk recipes for the treatment of obstructive bronchitis, which can also help in the treatment of COPD.

Infusions on herbal preparations. They are prepared by brewing a tablespoon of the collection with a glass of boiling water, each is taken for 2 months.

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

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

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

Healthy lifestyle, proper nutrition, physical education, respiratory exercises will help ensure a positive prognosis in curing the disease.