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(4) corticosteroids
for asthmatic bronchitis
(5) bronchial hygiene
���. Chronic asthmatic bronchitis (chronic persistent asthma)
: chronic bronchitis������ episodic airway obstruction��� ��쇱�쇳�� 寃쎌��
persistent airway obstruction
chronic productive cough
episodic bronchospasm
���. Chronic obstructive pulmonary disease

1. chronic bronchitis (chronic obstructive bronchitis)

2. emphysema

: diagnosed between ages 55 and 65
autopsy : 65% in adult men
15% in adult women

1) Pathogenesis

(1) smoking

smoker��� 50% - cough with sputum, 10-15%��� airway obstruction

��� protease

neutrophil elastase -> main
pulmonary alveolar macrophages -> possibly

��� counteracted by 慣1-antitrypsin (antiprotease), 慣2-macroglobulin

(2) familial and genetic factors
alpha 1-antitrypsin deficiency (protease inhibitor)
(Pi system)
Genetic type (gene phenoty���(������)

��� hepatitis in infancy

��� emphysema (panacinar) at lung base - 3rd, 4th, 5th decades

2) Pathology