만성폐쇄성폐질환

(4) corticosteroids for asthmatic bronchitis (5) bronchial hygiene Ⅲ. Chronic asthmatic bronchitis (chronic persistent asthma) : chronic bronchitis에서 episodic airway obstruction을 일으킨 경우 persistent airway obstruction chronic productive cough episodic bronchospasm Ⅳ. Chronic obstructive pulmonary disease 1. chronic bronchitis (chronic obstructive bronchitis) 2. emphysema : diagnosed between ages 55 and 65 autopsy : 65% in adult men 15% in adult women 1) Pathogenesis (1) smoking smoker의 50% - cough with sputum, 10-15%는 airway obstruction ① protease neutrophil elastase -> main pulmonary alveolar macrophages -> possibly ② counteracted by α1-antitrypsin (antiprotease), α2-macroglobulin (2) familial and genetic factors alpha 1-antitrypsin deficiency (protease inhibitor) (Pi system) Genetic type (gene phenotype) PiMM > 250mg/ml PiZZ < 50mg/ml - autosomal recessive PiSS PiMZ 50-250mg/ml (heterozygous, 3-5%) α1-antitrypsin deficiency ① hepatiti…
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