Chronic bronchitis - a chronic inflammatory disease of the bronchi, accompanied by a persistent cough with sputum production for at least 3 months per year for 2 years or more, while these symptoms are not associated with any other disease bronchopulmonary system, upper respiratory tract or other organs and systems .
Chronic bronchitis is a common disorder and occurs in 3-8% of the adult population. Most pulmonologists offer to provide primary and secondary chronic bronchitis.
Under the primary chronic bronchitis, chronic bronchitis understand as a distinct disease, not associated with any other bronchopulmonary disorders or lesions of other organs and systems. In primary chronic bronchitis there is a diffuse lesion of the bronchial tree.
Secondary chronic bronchitis is associated with chronic inflammatory diseases of the nose, paranasal sinuses, chronic inflammatory lung disease limited (chronic abscess) with previous pulmonary tuberculosis, with severe heart disease that occur with congestion in a small circle, with chronic renal failure and other diseases.
This article discusses the primary chronic bronchitis as a distinct disease.
The etiology of chronic bronchitis
Smoking and chronic bronchitis
Smoking - a major factor that causes chronic bronchitis, because of a significant spread of tobacco smoking among the population and due to its severe corrosive effects on the respiratory system and other organs and systems.
According to the Seventh World Congress on Smoking and Health, 1990 - Smoking was the cause of death of 3 million people.
In tobacco smoke revealed more than 1900 components that are toxic, mutagenic and carcinogenic effects (nicotine, "tar", consisting of polycyclic aromatic hydrocarbons, carcinogenic effect - cresol, phenol, radioactive polonium, carbon monoxide, nitrogen oxide, urethane, vinyl chloride, , hydrocyanic acid, cadmium, formaldehyde, etc.).
Now well established that cigarette smoking leads to the development of various bronchopulmonary diseases: chronic bronchitis (including chronic obstructive), bronchiolitis obliterans, emphysema, asthma, lung cancer and lung abnormalities in children.
According to epidemiological studies, the characteristic symptoms of chronic bronchitis appeared at the experience of smoking 15 - 20 years, and at the experience of smoking more than 20 - 25 years, there are complications of chronic obstructive bronchitis - cor pulmonale and respiratory failure. Among smokers chronic bronchitis occurs in 2 - 5 times higher than among non-smokers. The average life expectancy of a smoker for 15 years shorter than non-smokers.
The negative impact of tobacco smoke is evident not only in the active, and passive smoking (ie, while in smoke-filled room and the passive inhalation of tobacco smoke).
Inhalation of air pollution and chronic bronchitis
The frequency of chronic bronchitis among those living in regions with high air pollution, higher compared with those living in cleaner areas. This is because, breathing polluted air, the person inhales pollutants - aggressive substances of different nature and chemical structure, causing irritation and damage to the bronchopulmonary system. Air pollution usually occurs as a consequence of waste into the atmosphere of modern industrial production, combustion of fuels, "exhaust" gases.
The main indicators of air pollution are high concentrations of sulfur dioxide in it, and nitrogen, smoke. But, in addition, in polluted air may contain hydrocarbons, aldehydes, nitrates and other pollutants. Acute massive air pollution - could - could lead to severe exacerbation of chronic bronchitis. Smog is formed as a result of rapid air pollution by combustion products of fuel, in calm weather, accumulated under a layer of warm air, which is located in low lying areas of the layer of cold. Oxides of nitrogen and sulfur contained in the atmosphere, combined with water and lead to the formation of sulfuric and nitric acids, which significantly affects the inhalation of bronchopulmonary system.
Occupational exposures and chronic bronchitis
To occupational hazards that cause the development of chronic bronchitis include: the impact of different types of dust (cotton, coal, cement, quartz, wood, etc.) - the socalled dust bronchitis; influence of toxic vapors and gases (ammonia, chlorine, acids, sulfur dioxide, carbon monoxide, phosgene, ozone, fumes and gases produced in the gas and electric welding); high or, conversely, a low temperature, drafts, and other negative features of the microclimate in industrial premises and shops.
Climatic factors and chronic bronchitis
Development and exacerbation of chronic bronchitis promotes damp and cold climate. Exacerbations usually take place in autumn, winter and early spring.
Infection and chronic bronchitis
Most pulmonologists believe that infection is a secondary factor when they join later, when under the influence of the above-mentioned etiological factors already formed the conditions for infection bronchial tree. Thus, infection contribute to the exacerbation of chronic bronchitis, and much less is the root cause of its development.
Transferred acute bronchitis
Untreated acute protracted and recurrent bronchitis may cause a further development of chronic bronchitis, especially in predisposed individuals to it and in the presence of contributing factors.
Genetic factors, constitutional predisposition to chronic bronchitis
In the development of chronic bronchitis play an important role genetic factors and the constitutional predisposition. They contribute to the emergence of the disease when exposed to the above-mentioned etiological factors, as well as in the modified allergic reactivity. When family history of chronic bronchitis risk of developing the disease in the offspring (especially women) increases significantly, especially if the mother suffers from chronic bronchitis.
Factors predisposing to the development of chronic bronchitis: