新型呼吸系统.ppt

Respiratory system; Anatomy ;Rapid gas exchange Ventilation Perfusion Diffusion Cleaning the air Alveoli(300 million alveoli in two adult lungs, provide a surface area of some 160 meters square ) Surporting structure Elastic recoil;(1) the conducting airways (dead air space) ;(2) the gas exchange portions;气管;肺;Histology of the Airways ;Epithelium ;Bronchial Submucosal Glands ;Histology of the Alveolar walls ;Simple squamous Stretchy Permeable to O2 and CO2 Easily injured Do not divide ;Section 1 Chronic obstructive pulmonary disease ;Chronic Obstructive Pulmonary Disease (COPD);COPD represents a growing global public health problem.; 我国国家“十五”课题必威体育精装版统计数据（2005年公布）显示40岁以上人口COPD患病率为8%。估计全国有2500万人罹患此病，每年因COPD死亡的人数达100万，致残人数达500～1000万，COPD居我国疾病负担的首位。 ;一、慢支 Chronic bronchitis;Chronic bronchitis Endoscopic image;Pathogenesis;大气道病变 Large airway disease ;Reid index;鳞化 Squamous metaplasia;Chronic inflammation Hyperemia;小气道病变 Small airway disease;luminal and mucus;Pathologic changes;② 腺体变化;③ 管壁病变;小细支气管炎;Clinical features;晚期表现 Late stage menifestation;二、肺气肿Pulmonary emphysema ; Inadequate ventilation Less perfusion Narrowed bronchiole;Pathogenesis ;肺气肿类型 Types of emphysema;全小叶性肺气肿Penacinar (panlobular) emphysema 累及整个腺泡 下叶常见 1/20 as common as centriacinar emphysema. Seen in alpha-1-antitrypsin deficiency ;隔旁肺气肿 Distal acinar (paraseptal) emphysema或小叶周围性肺气肿 远端 The distal respiratory acinus is expanded 主要部位：上叶近胸膜或隔旁 ;Centriacinar (centrilobular) emphysema; Centrilobular emphysema in which there are dirty holes that appear focally where the central portions of lung acini have lost lung parenchyma while collecting anthracotic pigment at the same time. This pattern is typical for smokers ;Centriacinar (centrilobular) emphysema;Emphysema loss of alveolar walls;镜下 ： 肺泡壁、肺泡间隔 萎缩、消失、破坏， 互相融合;其它;Numerous large bullae apparent on the surface of the lungs in a patient dying with emphysema. ;临床病理联系 Late stage mani