Learn about the invisible killer in winter - chronic bronchitis

This is the 2845th article of Da Yi Xiao Hu

It's the beginning of winter, and Grandpa Wang is in the hospital again. He has been coughing so hard these past two days that he can't even breathe. He said, "Oh! This old problem comes back every winter, and it tortures me to death." Today, let's learn about Grandpa Wang's disease - chronic bronchitis.

1. What is chronic bronchitis?

Chronic bronchitis (chronic bronchitis) is a chronic nonspecific inflammation of the trachea, bronchial mucosa and surrounding tissues. Clinically, patients have cough, sputum and wheezing as the main symptoms. The disease lasts for 3 months each year. If it lasts for two years or more, it meets the diagnosis. Some people have the above symptoms for less than 3 months. If there is objective evidence in chest X-ray or CT, it also meets the diagnosis. Therefore, the characteristics of this disease can be simply summarized as "coughing and wheezing for two years and three months". However, there is a big premise for diagnosing chronic bronchitis. It is necessary to exclude other diseases such as tuberculosis and bronchiectasis that can also manifest as cough, sputum and (or) wheezing. It and emphysema are the most common diseases that cause chronic obstructive pulmonary disease (COPD). COPD has caused great trouble and economic burden to many families because it cannot be cured, continues to progress and is repeatedly hospitalized. Therefore, it is necessary for us to learn more about chronic bronchitis to avoid further development of the disease.

2. What are the pathological causes of chronic bronchitis?

Under normal circumstances, the human respiratory system has a perfect defense function, which can filter, warm and humidify the inhaled gas, and carry out effective gas exchange, provide oxygen to the human body and discharge carbon dioxide. With age, under the combined effects of systemic or local respiratory defense, decreased immune function and the accumulation of toxicity of various harmful factors, many people develop the disease after middle age and it is not cured. The following factors are common in clinical practice.

1. Smoking

It is the most common and main factor for the onset of the disease. Cigarettes contain chemicals such as tar, nicotine and hydrocyanic acid, which can damage airway epithelial cells, reduce cilia movement and macrophage phagocytosis, and lead to decreased airway purification function. Studies have shown that the prevalence of chronic bronchitis in smokers is 2 to 8 times higher than that in non-smokers. The longer the smoking age and the more cigarettes smoked, the higher the prevalence.

2. Air pollution

Harmful gases such as sulfur dioxide, nitrogen dioxide, chlorine and ozone have irritating and cytotoxic effects on the airway mucosal epithelium.

3. Infectious factors

Repeated respiratory tract infection is one of the important factors in the occurrence and development of chronic bronchitis. Virus, mycoplasma and bacterial infection are the main causes of acute attacks of this disease.

4. Cold weather

Chronic bronchitis attacks are more common in autumn and winter, so meteorological factors such as cold weather should be considered as one of the important factors for the onset of the disease. Cold air can stimulate the glands to secrete more mucus and weaken the movement of cilia, weakening the airway's defense function.

5. Others

Allergic factors, autonomic dysfunction, changes in nutritional status, age and genetic factors may all be involved in the occurrence of this disease.

3. What are the symptoms of chronic bronchitis?

1. Cough

In the early stage, the cough is more severe in the morning, lighter during the day, and more obvious at night in the late stage. There are often paroxysmal coughs before going to bed, accompanied by sputum. As the disease progresses, the cough does not heal all year round.

2. Coughing up phlegm

The sputum is usually more in the morning, and is usually white mucus or serous foam, some of which may be yellow and occasionally bloody. When an acute attack is accompanied by bacterial infection, the amount of sputum increases, and the sputum becomes more viscous or purulent.

3. Shortness of breath and wheezing

In the early stages of the disease, symptoms are usually not obvious. When the disease progresses and is complicated by obstructive pulmonary emphysema, shortness of breath of varying degrees gradually appears, which worsens after activity. In the late stages of the disease, when pulmonary heart disease and heart failure occur, in addition to shortness of breath of varying degrees, there will also be complications of right heart failure symptoms such as limb edema, loss of appetite, and abdominal distension, which require oxygen inhalation to relieve the symptoms.

4. How to prevent and care for it?

1. Quitting smoking and minimizing exposure to secondhand smoke are important measures to prevent chronic bronchitis. They can slow the decline of lung function, but cannot reverse already damaged lung function.

2. Control occupational exposure and environmental pollution to avoid inhalation of harmful gases such as dust and smoke. Strengthening health education, improving working conditions and hygiene habits, and increasing nutrition can all play a positive role in preventing chronic bronchitis.

3. Strengthen exercise, improve physical fitness and immunity. Injection of influenza vaccine, pneumococcal vaccine, etc. may be of certain significance in preventing susceptible people.

4. It is also very important to monitor lung function regularly to detect airflow limitation early and take timely measures. Once it progresses to chronic obstructive pulmonary disease, home oxygen therapy and regular disease assessment and intervention can effectively delay disease progression and improve the patient's quality of life.

5. Maintain appropriate indoor temperature and humidity and good ventilation. Pay attention to the air quality reports issued by the local meteorological department and avoid going out in severely polluted weather.

6. Pay attention to the combination of work and rest and ensure adequate sleep.

7. Drink plenty of water and eat light, nutritious and easily digestible food.

Author: Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University

Written by Party Training Nurses

Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University

Chief Physician Pei Honghong