Enfermedad pulmonar obstructiva crónica (EPOC). Bases para el médico general / Chronic Obstructive Pulmonary Disease (COPD). Bases for the General Practitioner

Resumen La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad crónico-degenerativa frecuente, prevenible y tratable, caracterizada por persistentes síntomas respiratorios y limitación del flujo aéreo. En 2016, el Instituto Nacional de Enfermedades Respiratorias (INER) la ubicó en el cuarto lugar en la tabla de morbi-mortalidad anual en México. Su prevalencia está directamente relacionada con la del tabaquismo; sin embargo, su desarrollo es multifactorial. Para el estudio de la EPOC es importante conocer los antecedentes de exposición a factores de riesgo y la presencia de los principales síntomas; es esencial una historia clínica bien detallada, donde se recabe la mayor cantidad de datos de todo nuevo paciente en el que se conozca o se sospeche de la enfermedad, así como una espirometría para establecer el diagnóstico. Debido a la gran variabilidad que existe entre los pacientes con EPOC, es necesario establecer tratamiento farmacológico individualizado. Los fármacos utilizados en su tratamiento reducen los síntomas, la frecuencia y la gravedad de las exacerbaciones; sin embargo, no hay ningún medicamento que modifique el deterioro a largo plazo de la función pulmonar. Por lo tanto, el conocimiento básico de este padecimiento por el médico de primer contacto es esencial para la sospecha en una etapa inicial, y así ofrecer al paciente una intervención médica inmediata. El presente trabajo tiene la finalidad de acercar al médico general una visión básica de la EPOC.

Abstract Chronic obstructive pulmonary disease (COPD) is a chronic degenerative disease. It is a frequent, preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation. The National Institute of Respiratory Diseases (INER), ranked COPD in 2016 in fourth place in the table of annual morbidity and mortality in Mexico. The prevalence of COPD is directly related to smoking; however, its development is multifactorial. For its study it is important to know of any prior exposure to risk factors and of any manifestation of the main symptoms. To make a diagnosis, a detailed clinical history, where the largest amount of data is collected from every new possible COPD patient, and a spirometry are essential. Individual pharmacological treatment is necessary due to the great variability among COPD patients. The drugs used in the treatment of COPD reduce the symptoms, the frequency and severity of exacerbations; however, there is no medication that modifies the long-term deterioration of the lung function. Therefore, a basic knowledge of this condition by the medical doctor first contacted, is essential for the suspicion of COPD in its initial stage and thus, offer the patient immediate medical intervention. The objective of the present work is to provide a basic overview of COPD to the general practitioner.

Pathophysiology of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease that is characterized by irreversible airflow limitation with a partially reversible component. The pathologic abnormalities of COPD are associated with lung inflammation, an imbalance of proteinases and antiproteinases, and oxidative stress that are induced by noxious particles and gases in susceptible individuals. The physiologic changes of COPD are mucus hypersecretion, ciliary dysfunction, airflow limitation, pulmonary hyperinflation, gas exchange abnormalities, pulmonary hypertension, cor pulmonale, and systemic effects. The airflow limitation results principally from an increase in the resistance of the small conducting airways and a decrease in the pulmonary elastic recoil due to emphysematous lung destruction. This article provides a general overview of the pathophysiology of COPD.

Pathophysiology of Chronic Obstructive Pulmonary Disease / 결핵및호흡기질환

Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease, characterized by irreversible airflow limitation, with a partially reversible component. The pathological abnormalities of COPD are associated with lung inflammation, imbalances of proteinase and antiproteinase, and oxidative stress, which are induced by noxious particles and gases in susceptible individuals. The physiological changes of COPD are mucus hyper-secretion, ciliary dysfunction, airflow limitation, pulmonary hyperinflation, gas exchange abnormalities, pulmonary hypertension, cor pulmonale and systemic effects. The airflow limitation principally results from an increase in the resistance of the small conducting airways and a decrease in pulmonary elastic recoil due to emphysematous lung destruction. This article provides a general overview of the pathophysiology of COPD.