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()

()


()


-
(FVC)

5
4
3

1 (FEV1) = 4L
(FVC) = 5L

1/ (FEV1/FVC) = 0.8
1

5
4

FEV1 = 1.8L

FVC = 3.2L

FEV1/FVC = 0.56
1

Obstructive

5
4
3

FEV1 = 1.9L
FVC = 2.0L

FEV1/FVC = 0.95
1


(PEF)

L/sec

L/sec

(L)

(L)

(L)

(L)

200 400 g

15

500 g Turbohaler

15

160 g

45

, 1
15% 200

** Usually 8 puffs of 20 g



1 < 80%
1/ < 70%

> 400 ml

< 400 ml

30 mg
2

< 400 ml

1
> 400 ml



.
,


, .

, ,


( American Thoracic Society).

: ,
.
: ,
(
),
( ).
: , .
, ( ,
, , ,
, .)

: ( 20 ),
( 12 ).
:
,
( ),
(
) .
:
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.

,
.
: ,
, , () .
(
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,
.

( , , ,
.).


,
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.
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,
.

Source: Masoli M et al. Allergy 2004

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-


510
(
).
,
30
45


1 ;


(1)

( )
( )

2
3
4
()


60 / ( 20% ,
)

20% ( 2
10%)

( )

(
)

( 2
)

( 2
)


( 1)

< 80%

:
,



- 2



-IgE


(/)


(/)


(/)

200-500

500-1000

>1000

200-600

600-1000

>1000

80160

160-320

>320-1280

500-1000

1000-2000

>2000

100-250

250-500

>500

200-400

400-800

>800-1200

400-1000

1000-2000

>2000

2-




2-

,

NHLBI/NAEPP, , 2007

British Thoracic Society,


, 2008

,
,



.
..

,
.

- .

IgE



3.0
3.0
2.5
2.5

59%

64%

35%

+163%

7%

2.0
2.0
1.5
1.5
1.0
1.0
0.5
0.5
0.0 0

1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998
Source: NHLBI/NIH/DHHS


102 .

5,600

---

Centre fdral dexpertise


des soins de sant

530

1,078

Piperno et al. 2003

2,724

216

Social costs of asthma


and COPD in Italy

Source: Peter J. Barnes, MD

Source: Peter J. Barnes, MD

January 2009

Treating COPD and Asthma


Mucusdoc@hotmail.com

CD4+
(Th2)

CD8+ cell
(Tc1)

Source: Peter J. Barnes, MD

100%


35

FEV1/FVC

FEV1 %

>0.7

80

0.7

80

0.7

5080

0.7

3050

0.7

<30 <50 +

:
:

-

-

-

-

FEV1
(A)
(A)
(A)
(A)
(A)
(A)

(B)
(B)
(A)
(A)
NA
(B)

(B)
NA
(B)

(B)

(B)
NA
NA

(B)
NA

(A)
(A)
(A)
(A)
(B)
(A)

NA
(B)
(A)
(A)
(A)
(B)


NA

NA

NA

NA

NA

NA


I:

II:

III:

IV:

FEV1/FVC < 70%

FEV1/FVC < 70%

FEV1/FVC < 70%

FEV1 > 80%

50% < FEV1 < 80%

FEV1/FVC < 70%


30% < FEV1 < 50%

FEV1 < 30%

FEV1 < 50%


+

50%

25%

20%

5%

,
,

Wedzicha JA, Seemungal TA.


Lancet. 2007;370:786-796.

2- / ( )

( )

( 3040 mg 10 )

, :
/

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