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慢性阻塞性肺疾患(chronic obstructivepulmonary disease,简称 COPD)一词已沿用近20年,一般的看法是 COPD 病人(主要是慢性支气管炎和肺气肿)的主要肺功能障碍来自气管的堵塞。1979年,Menkes、Permutt 及Chen 提出了“慢性通气受限”(chronicairway limitation,简称 CAL)的概念,认为这类病人的主要表现是通气(或气流)受限。呼出气流大小取决于肺内压力及气道的阻力。所以通气受限既可由于气道狭窄(由于分泌过度或支气管痉挛)从而增加阻力引起;亦可在气道阻力正常的情况下,由于肺失去弹性回缩功能,从而减少肺内压力造成(图1)。故采
The term chronic obstructive pulmonary disease (COPD) has been used for almost 20 years and the general perception is that the main lung dysfunction in COPD patients (mainly chronic bronchitis and emphysema) is from tracheal blockage. In 1979, Menkes, Permutt, and Chen proposed the concept of “chronicairway limitation” (CAL) as the primary manifestation of such patients being restricted ventilation (or airflow). Exhaled air flow depends on the size of the lung pressure and airway resistance. Therefore, ventilation restriction may be due to narrowing of the airway (due to excessive secretion or bronchospasm) thereby increasing resistance; also in the case of normal airway resistance, due to loss of elastic recovery of lung function, thus reducing the pressure caused by the lung 1). Therefore mining