fibrosis - a disease characterized by the emergence and subsequent growth of connective tissue in the lungs.This condition is not fully independent disease.Rather, it is the outcome (consequences) of certain lesions of the pulmonary system.
fibrosis refers to the total group pnevmoskleroticheskih diseases.Also in this group, it also exist lung fibrosis and cirrhosis.These subtypes differ in intensity of connective tissue growth in the lung.Among them are pulmonary fibrosis is characterized by the slowest rate of growth of connective tissue, and multiple sclerosis and cirrhosis - faster.
fibrosis are divided into local and diffuse fibrosis.Diffuse pulmonary fibrosis characterized by the appearance of large areas of lung tissue replacement connective tissue.At a local variant of pulmonary fibrosis (focal fibrosis), all processes will be centralized in one any locus (locus) and will rarely go beyond its borders.
Now fibrosis began to appear much like most.This can be attributed to
fibrosis - a disease that consists of a variety of causes.As mentioned above, fibrosis never arise by itself.In order that it appears to be a mandatory presence of the so-called primary diseases and conditions that lead to the development of pulmonary fibrosis.The most basic of these is:
- various infectious agents and pneumonia
- exposure to toxic substances, dust
- Injuries to the thorax, affecting the lungs
- Consequences of tuberculosis
- Results of disease affecting connective tissue
- Damagecaused by fungi and parasites
- Consequences of failure, left ventricular function and the subsequent stagnation of blood in the pulmonary vessels
as has become clear, a major pathological mechanism that will occur in the lungs with pulmonary fibrosis, will be the replacement of the pulmonary connective tissue.The reasons for its occurrence when fibrosis vary depending on the underlying disease that caused pulmonary fibrosis.For example, the connective tissue in the lungs may occur as a result of the organization of inflammatory exudate (a vivid example - pulmonary fibrosis resulting from inflammation of the pleural lesions).Also, it may occur due to the direct toxic effects on the lung cells of inhaled substances.As a result, they will die, and then will be replaced by connective tissue.
But the most common cause of connective tissue in the lungs when replacement fibrosis - this is undoubtedly the lung tissue hypoxia.The fact that lung tissue hypoxia trigger cell activation, fibroblasts.These fibroblasts in response to hypoxia, will quickly and in large quantities to produce collagen.It will be a subspecies of collagen and connective tissue, which will replace the lung.
Besides the main "connective" mechanism of pulmonary fibrosis, there are also around three main "key" the causes of the disease.It is a violation of ventilation, drainage and bronchi damage adequate circulation and lymph circulation.
Violation ventilation stems directly from the main mechanism of pulmonary fibrosis, and it can be explained as follows.In normal lung tissue elastic enough and that its elasticity plays an important role in the process of respiration.The higher elasticity of the lung tissue, the greater the force of the body will need to stretch the fabric as possible.Therefore, high levels of injected intrapulmonary pressure.In turn, high level poddavlivat intrapulmonary pressure inside wall of the alveoli and thus spreading it on inhalation.
But fibrosis already impressed many alveoli connective tissue.In contrast to the lung, this type of fabric has virtually no elastic properties.The lower the elasticity of the fabric of the alveoli, the easier it will be possible to stretch out.This means that the body will not have to apply more force to stretch.Therefore, the level of pulmonary pressure decreases.But such a low level of pressure will not be able to disclose the alveoli, and the wall will subside.As a result, part of the lung tissue just turn off from the general system of oxygen enrichment: unopened alveoli can not be filled with oxygen and pass it through the capillaries in your body.
Violation of bronchial drainage function is due to the inflammatory condition of the bronchial walls due to its inflammatory swelling.As a consequence of impaired outflow of secretions, and it accumulates.These deposits bronchial secretions are favorable for the development of infection in them, which will cause a secondary inflammatory flare around easily.
in turn will lead to a blockage of the bronchus that violated certain lobe contact with inhaled air.Again, this will cause that violated the processes of pulmonary pressure and the proportion of light just subsides.
Also inflammatory disorder of the normal drainage bronchus, pulmonary fibrosis can be a cause of dysmotility bronchi secretion.Typically, they occur in violation of the neuromuscular component of the bronchi.
Limfooobraschenie and blood circulation can be broken due to compression of blood vessels in the lungs.Circulation can also disrupt and cause pulmonary fibrosis if the vessels surrounding the lung congestion processes begin.Most often, these congestions may occur due to spasm of blood vessels, or inflammation that narrows the lumen.After a long stay in a static vessels, stagnant fluid gradually starts to pass through its wall (propotevat) forming protein effusion.This protein effusion gradually grows connective tissue, which is then gradually replaces individual alveoli (usually those that are located near the site of stagnation).Again, developing fibrosis.
Thus, you can select a specific chain of major changes in the pulmonary fibrosis.First, the primary affected lung tissue disease, a light affects its main pathological factor.This factor is divided into the following types: impaired pulmonary ventilation problem in the drainage function of bronchi or disorders of the lymphatic vasculature and lungs.Each of these factors will be accompanied by the replacement of normal lung tissue pathological coupling.
Each factor in the occurrence of connective tissue develop in different ways: someone they will become the root cause (as violations of pulmonary ventilation), someone will be a consequence.But all three of the reasons they are necessary.Next, there will be some loss of lung tissue from the mechanism of breathing, and the body will develop a specific subtype of respiratory failure and metabolic gases between the alveoli, blood vessels and tissues.
Symptoms of pulmonary fibrosis
fibrosis has local and diffuse manifestations.In general, most clinical pulmonary fibrosis was seen in patients with the second form, since the focal fibrosis disease clinic may not occur (because of less systemic lesions).
The clearest indication that the defeat of the lung tissue to be short of breath.First, it will occur during physical exertion, and then will appear alone.Often it is accompanied by a strong cough and separating viscous, purulent sputum.Visually, the patients will be found for common cyanosis (it arises because of strong hypoxia in the lung).
possible chest pain aching, fatigue, dramatic weight loss, general weakness.When a primary lesion of the basal parts of the lungs, often formed "Hippocratic fingers" (so-called drumsticks).
Patients may complain of fairly strong pain in the chest, appearing for coughs.You can listen in the lower parts of the lungs wheezing, as well as the characteristic "sound of friction plugs", which is a sign of advanced disease pulmonary fibrosis.
the presence of complications may begin to show signs of failure of small blood circle: hemoptysis, sputum streaked with blood, etc.
addition to the above features, typical for pulmonary fibrosis, are also signs of primary disease: symptoms such as pneumonia or bronchitis.
most important diagnostic criterion fibrosis - this, of course, the X-ray light.It allows you to find the first signs of the disease, and to identify the presence of comorbidities.In addition, this study will help to distinguish fibrosis and lung cancer for similar symptoms.
main feature of pulmonary fibrosis is increased pulmonary pattern and deformation.Expanding the shadow vessels, and the affected department can even see the shadows of some small branches of vessels with their impaired direction.You can also find the so-called "pulmonary shadow" with jagged and sharp contours.These shadows are the portions of the damaged lung.
In advanced stages on x-rays can find signs of the complete connective tissue structures of the lungs: the shadow-line in different, chaotic lines, dense and abdominal areas (like "honeycomb") and deformed scars lung roots (root fibrosis).
second important research will study the function of the external breathing.Evaluate the special value - the index Tiffno.Its decrease (usually less than 70%) is a sign of violation of external respiration.This index measures the volume of the lungs examined: VC (vital capacity) and FVC (functional vital capacity).For pulmonary fibrosis is characterized by its reduction.Such a change in the above figures is called restrictive and is characteristic of the disease affecting the lung tissue.
third point of the research plan will bronchoscopy study.Usually it helps to separate focal fibrosis from diffuse.In the diffuse form of the disease is observed no change in the cavity of the bronchus, with focal - can be found bronchiectasis (bronchiectasis).
mainly in the treatment of pulmonary fibrosis is the elimination of the causes and treatment of the primary disease.
If you have pneumonia need to designate a good antibacterial therapy.Often, a combination of drug therapy and physical training.When fibrosis, pneumonia should be treated until complete clinical and radiological recovery.After treatment, these patients are placed on the active account, which lasts for about 1 year.
as patients with pulmonary fibrosis appointed expectorants (Bromhexine) and a special "drain" position in the bed, which will help to move away phlegm.If
fibrosis complicated by inflammatory processes, then, as in pneumonia, are assigned certain antibacterial scheme: best suited for their drugs from a number of macrolides and tsefallosporinov.It is important to know that the number of infectious agents fibrosis in the lungs may exceed a few dozen, so it is advisable to use antibiotics with a wide spectrum of action.At the appointed antibiotics glucocorticoids.
If the root cause of cardiac disease or cardiac insufficiency, which has evolved as a result of pulmonary fibrosis, prescribers cardiac glycosides.The most frequently used Strophanthin or Korglikon.
also can not forget about vitamin therapy and physiotherapy.The stages of fibrosis without pulmonary disease have a good effect of ultrasound and iontophoresis treatments with drugs.
Even if fibrosis is assigned to oxygen therapy.It saturates the lungs with oxygen, which affected lung disease is lacking.Typically oxygen is fed in such an amount in which it is present in the ambient atmosphere.
And you can not miss another important point of treatment - is the appointment of special respiratory movements.They improve respiratory function and support the body and help provide oxygen sleeping areas of the lungs.
Prevention of pulmonary fibrosis is the proper treatment of primary diseases that cause pulmonary fibrosis.We need time to identify and treat diseases such as bronchitis and pneumonia, before they go into the stage of complications.It is also important to give up bad habits, especially smoking.
addition must clearly adhere to safety precautions when working with toxic substances to the lung cells: the need to use masks and respirators.If an employee of the production will be revealed fibrosis, it is necessary to immediately transfer him to another job.