Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by persistent airflow limitation. Its essence is the persistent and progressive airflow limitation caused by airway (bronchitis, bronchiolitis) and/or alveolar abnormalities (emphysema). As a global health problem, COPD is like an "invisible thief" that steals our breathing freedom silently, affecting the quality of life of hundreds of millions of people. The global prevalence of COPD is about 10.3%, and the prevalence of people over 40 years old is higher than that of people under 40 years old (the prevalence increases with age), males are higher than females (11.8% vs. 8.5%), and there is an increasing trend for females, and smokers are higher than non-smokers. In China, the prevalence of COPD in people over 20 years old is 8.6%, nearly 100 million people. If the age is limited to people over 40 years old, one in every eight people has COPD (13.7%). COPD is currently the third leading cause of death in the world; more than 3 million people die from COPD each year; it is predicted that by 2060, the number of people who die from COPD and its related diseases will exceed 5.4 million per year.
COPD symptoms: more than just a cough
Chronic cough: a long-term and persistent cough, especially in the morning and evening. This is not an ordinary cough, it may become a daily "wake-up call" for the whole family. -
Expectorant: coughing is accompanied by sputum, which may be white mucus or yellow purulent.
Dyspnea: shortness of breath and dyspnea occur after activity. As the condition worsens, dyspnea may also be felt in a calm state. Imagine that every breath is like climbing Mount Everest, which is the daily life of COPD patients.
Chest tightness and shortness of breath: there is a sense of oppression in the chest and breathing is not smooth.
Barrel chest: the anterior-posterior diameter of the chest increases, forming a barrel chest.
As the disease progresses, the patient's lung function further deteriorates. In the stage of moderate COPD (GOLD level 2), the patient's lung function is moderately impaired, and the FEV1 accounts for 50%-79% of the predicted value. Patients may experience shortness of breath, especially when active. Further deterioration, many patients will have various directly or indirectly related complications, such as: bronchiectasis, insomnia, weakness, cognitive impairment, anxiety and depression, hypertension, cardiovascular disease, oral and periodontal infection, gastroesophageal reflux, polycythemia, etc. Most patients have an acute exacerbation every 4 months on average, which may eventually lead to death.
In order to treat COPD, in Europe, direct costs of respiratory diseases account for about 6% of the total health budget, and COPD accounts for 56% of respiratory disease costs; in the United States, it costs about $40 billion per year.
The "culprit" of COPD: smoking and environmental pollution are the main culprits
Long-term smoking: smoking is the main cause of COPD.
Occupational exposure: long-term exposure to harmful dust and chemical gases.
Environmental pollution: indoor and outdoor air pollution.
Bronchial asthma (abbreviated as asthma) and airway hyperresponsiveness: Asthma can not only coexist with COPD, but is also a risk factor for COPD. Airway hyperresponsiveness is also involved in the pathogenesis of COPD.
Low body mass index: The lower the body mass index, the higher the prevalence of COPD.
Genetic factors: Some people may be more susceptible to COPD due to genetic reasons.
Diagnosis of COPD The diagnosis of COPD is usually based on medical history, symptoms and lung function tests. Pulmonary function tests (such as spirometry tests) can assess the degree of airflow limitation. In addition, there are many professional scales that help further assess the severity of the disease and guide the designation of different treatment plans.
Treatment of COPD: Not just "the right medicine for the right disease"
General treatment:
- Quit smoking, respiratory function training, vaccination, and prevent lung infection.
- Oxygen inhalation. Due to the nature of COPD, the disease is destined to be a protracted battle. So when it comes to oxygen therapy, home oxygen therapy and home non-invasive ventilation therapy are particularly important. Studies have shown that long-term oxygen therapy can improve survival in patients with severe hypoxemia at rest.
Medications:
- Bronchodilators: used to relieve dyspnea.
- Glucocorticoids: used to reduce airway inflammation.
- Phosphodiesterase-4 (PDE-4) inhibitors: used to improve symptoms and lung function.
Acute treatment:
- During an acute exacerbation, hospitalization may be required, including antibiotics, hormones, and oxygen therapy.
COPD Treatment Outlook
Although there is no cure for COPD, the future looks promising in terms of treatment options for the disease, primarily because COPD is the leading cause of death worldwide. This means that a great deal of attention has been paid to it, with a great deal of resources and energy invested in finding innovative, effective treatments. Recent breakthrough treatments and those currently under development also mean that the quality of life and overall health of people with COPD continues to improve. And, with more research being invested specifically in regenerative medicine, promising treatments for COPD are likely on the horizon.
