Chronische obstruktive Lungenerkrankung: Pathophysiologie, Diagnostik und Therapie

Zusammenfassung

Die COPD (chronic obstructive pulmonary disease) ist eine hauptsächlich durch inhalative Noxen, vornehmlich Zigarettenrauchen, hervorgerufene Erkrankung, die in der Todesursachenstatistik weltweit auf einem der führenden Ränge liegt. Es handelt sich um eine chronisch entzündliche Systemerkrankung, die in der Lunge zu einer chronischen Bronchitis und Emphysem führt. Zunehmend wird erkannt, dass die COPD ein Syndrom mit verschiedenen Phänotypen darstellt. Von klinischer Relevanz ist auch, dass die COPD häufig mit anderen Erkrankungen gemeinsam auftritt (kardiovaskuläre Krankheiten, Angst, Depression, Diabetes, Osteoporose). Die Diagnose basiert auf der Klinik, der Bestimmung der Lungenfunktion und der Suche nach Komorbiditäten. Mit inhalativen langwirksamen Bronchodilatatoren, inhalativen Steroiden oder Phosphodiesterase-Inhibitoren können Verbesserungen bezüglich der Lebensqualität und der körperlichen Belastbarkeit oder eine Reduktion von Exazerbationen erreicht werden. Eine Reihe nichtpharmakologischer Maßnahmen wie Nikotinentwöhnung, hochkalorische Ernährung, O₂-Therapie, Physiotherapie, Rehabilitation, Heimbeatmung, Lungenvolumenreduktion und Lungentransplantation sollten individuell erwogen werden.

Abstract

Chronic obstructive pulmonary disease (COPD), a complex disease triggered mostly by exposure to cigarette smoke, is a leading cause of morbidity and mortality worldwide, leading not only to pulmonary damage but also to systemic impairment. There is growing awareness of systemic inflammation and cardiovascular, neurologic, psychiatric, and endocrine comorbidities associated with COPD. The diagnosis of CODP is based upon the clinical presentation, measurement of the pulmonary function, investigation of comorbidities and exclusion of differential diagnoses. COPD is a heterogeneous disease including various phenotypes. A number of drugs reduce or alleviate symptoms, increase exercise capacity, or reduce the number and severity of exacerbations. Non-pharmacologic measures such as smoking cessation, nutritional support, long term oxygen therapy, physiotherapy, rehabilitation, lung volume reduction and lung transplantation may be available for appropriate patients and can improve health status.

Schlüsselwörter

Chronisch obstruktive Lungenerkrankung - Luftnot - Physiotherapie

Keywords

Chronic obstructive pulmonary disease - Dyspnea - physiotherapy

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