The prevalence rate among people over 40 years old is 8.2%. Are you one of them?

Author: Lin Jiangtao, Chief Physician of China-Japan Friendship Hospital

Reviewer: He Quanying, Chief Physician, Peking University People's Hospital

Epidemiological surveys show that 8.2% of adults over 40 years old in my country suffer from chronic obstructive pulmonary disease (COPD). Based on this data, it is estimated that there are nearly 100 million such patients in my country.

1. What exactly is COPD?

COPD is the most common chronic respiratory disease. In our country, it is listed as one of the four common chronic diseases, in addition to hypertension, malignant tumors, and diabetes, the fourth is called chronic respiratory disease, which mainly includes two diseases, namely bronchial asthma and COPD.

The so-called "chronic" means that the disease has a chronic process from occurrence to development.

From the perspective of onset, this disease is very hidden, and the early symptoms are not very typical, so it usually does not attract everyone's attention. When many patients seek medical treatment, their lung function damage is often very serious and they have obvious breathing difficulties.

Figure 1 Original copyright image, no permission to reprint

How does this disease occur? It means that our respiratory tract, including the airway and lung tissue, inhales various harmful gases or particles from the outside world, which causes an inflammatory reaction in the airway and lung tissue, eventually resulting in airway obstruction, restricted airflow, and the patient experiencing dyspnea.

This airflow limitation often develops progressively and cannot be fully restored to normal. It is currently believed that this disease will repeatedly worsen acutely or develop some complications, which will seriously affect the patient's daily activities and may even lead to death, causing a very serious disease burden on the patient.

2. Who is prone to COPD?

First, people over 40 are more likely to suffer from COPD because this disease rarely occurs in young people and basically occurs in people over 40 years old.

Second, people who smoke a lot for a long time, generally more than 400 cigarettes a year, belong to the high-risk group. The smoking index of 400 cigarettes a year means the number of cigarettes smoked per day multiplied by the number of years of smoking. For example, if someone smokes 20 cigarettes a day for 20 years, his smoking index is 400, which means he belongs to the high-risk group.

Third, in some special occupational environments, long-term exposure to harmful gases and harmful dust, and inhalation of these particles can easily lead to the occurrence of COPD.

The fourth is that there are patients with COPD in the family, that is, there is a family history of COPD, and the offspring of COPD patients are also prone to the disease.

In addition, people who have other respiratory diseases, such as asthma, or who had recurrent respiratory infections in childhood are also prone to COPD.

If the above-mentioned people have repeated coughing and sputum production, and have symptoms of difficulty breathing and shortness of breath when at rest or during strenuous activity, they should go to the hospital for a lung function test as soon as possible. If the exhaled airflow is limited, it means that airway obstruction has occurred, so that COPD can be diagnosed and treated early.

3. How should patients with COPD be treated on a daily basis?

The daily treatment of COPD patients refers to the treatment during the stable period of the disease. Through the treatment during the stable period, the acute exacerbation of the disease can be reduced, the patient's clinical symptoms can be improved, and the quality of life can be improved. This is very important.

During the stable period, some treatments are general, such as preventing respiratory infections, which are the triggering factors that aggravate the disease. Patients should exercise regularly, strengthen their physique, and prevent colds, etc. Vaccinations should be given when necessary, such as influenza vaccinations before winter every year, or pneumococcal vaccinations, etc.

Of course, general treatment also includes nutritional supplementation intervention. Because patients with COPD have difficulty breathing and increased respiratory rate, the energy consumed by breathing is very large. Therefore, some very thin patients have severe malnutrition, and the calorie intake of these patients in their diet should be relatively high.

In addition, in terms of nutrient supplementation, a high-protein, low-fat, low-carbohydrate diet should be adopted. This is because when fat and especially carbohydrates generate energy in the body, the amount of carbon dioxide produced will increase, which will increase the burden of breathing. In addition, some minerals and vitamins can be supplemented.

There is another point in general treatment, that is, patients with breathing difficulties need to undergo arterial blood gas analysis. If the arterial oxygen partial pressure is lower than 55 mmHg, or the arterial oxygen saturation is lower than 88%, these patients must undergo long-term oxygen therapy.

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The so-called long-term oxygen therapy means that the daily oxygen inhalation time should reach more than 15 hours. These 15 hours may include the patient's oxygen inhalation while sleeping. The benefits of long-term oxygen therapy for these patients are very significant.

First, the symptoms of dyspnea will improve, the mind will become clearer, and things that could not be remembered before can be remembered, because lack of oxygen will affect his memory and even orientation, and will also cause distressed emotions, dizziness, headaches, etc. These common symptoms can be improved.

Second, the greater benefit of oxygen therapy is that it can significantly prolong life. Currently, it has been confirmed that in the intervention treatment of COPD, the two methods that can prolong life are quitting smoking and oxygen therapy.

In addition to this, there is drug treatment. The most important drug is bronchodilator, which can relieve the patient's symptoms of shortness of breath and difficulty breathing by dilating the trachea, and significantly improve the patient's quality of life.

We now recommend the use of long-acting bronchodilators as maintenance medication, that is, once or twice a day, for example, once before going to bed at night. The degree of dyspnea in the morning can be significantly reduced, and the ability to tolerate activities after getting up can be improved. If you use it long-term, for one, two, three, four years, or even longer, the symptoms will continue to improve, and the number of exacerbations will also decrease.

In addition, patients with concurrent bacterial infections may need to use antibiotics, and patients with large amounts of sputum may need to use expectorants, etc.

In short, the treatment of COPD patients in the stable phase emphasizes comprehensive treatment, and must be personalized under the guidance of a doctor and based on the different clinical conditions of each patient.