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Emphysema of the lungs: an overview of information
Last reviewed: 23.04.2024
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Emphysema of the lungs is a pathological process characterized by the expansion of the alveoli located distal to the terminal bronchioles and accompanied by destructive changes in the alveolar walls (elastic fibers of the lung tissue).
The prevalence of emphysema is more than 4%, and according to autopsy it is recorded in dead men in 60% and in women - in 30% of cases.
The frequency of emphysema increases significantly after 60 years. Emphysema of the lungs refers to chronic obstructive pulmonary diseases.
By origin, distinguish primary (genovinuyu or idiopathic) lung emphysema, in which bronchial obstruction is a complication, and secondary (obstructive) emphysema, which complicates the course of chronic bronchitis.
[Causes of emphysema
Smoking is considered one of the most aggressive factors in the development of chronic obstructive pulmonary disease in general and emphysema in particular. The development of emphysema in smokers is due to the fact that tobacco smoke causes the migration of neutrophils to the terminal section of the respiratory tract. Neutrophils produce large amounts of proteolytic enzymes elastase and cathepsin, which have a destructive effect on the elastic base of the alveoli.
In addition, chronic smoking in alveolar macrophages accumulates tar of tobacco smoke, and the formation of alpha-1 antitrypsin in them sharply decreases.
Symptoms of emphysema
The main complaint of patients with emphysema is shortness of breath. At the onset of the disease, it occurs only with considerable physical exertion, then with progression, emphysema acquires a permanent character. With the development of bronchial obstruction, dyspnea becomes expiratory.
Dyspnea with primary emphysema differs from dyspnea with secondary emphysema. With the primary emphysema of the lungs, the character of breathing changes: the breath becomes deep, and the exhalation is prolonged, through closed lips. Patients tend to increase during exhalation the pressure in the airways, so on exhalation they cover their mouths and inflate their cheeks, which reduces the expiratory collapse of small bronchi. This type of breathing resembles puffing.
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Diagnosis of emphysema
X-ray examination of the lungs and heart. Characteristic features of emphysema are the low position of the dome of the diaphragm and its flattening, markedly reduced diaphragm excursion; increased airiness of pulmonary fields; an increase in the retrosternal space (a sign of Sokolov); impoverishment of pulmonary fields with vascular shadows (the vascular pattern acquires a threadlike character and considerably weakens to the periphery). The cardiac shadow is narrowed, elongated ("drip heart").
For pulmonary emphysema, hyper-airyness of the lung tissue is characteristic, depletion of the vascular pattern, in comparison with the usual radiographic examination, bullae are clearly identified.
In the presence of chronic bronchitis high density of the bronchial wall, infiltration along the course of bronchi is revealed.
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