What are the three types of respiratory diseases

In the most commonly used classifications in clinical practice, high-incidence respiratory diseases are mainly divided into three categories: infectious respiratory diseases, airway obstructive respiratory diseases, and neoplastic respiratory diseases.

This is also the most common type we encounter in our daily life. More than 70% of patients in the recent peak season of autumn and winter have this kind of problem. Last week, I received a 10-year-old patient at the respiratory clinic. He coughed on and off for 12 days and had repeated low fevers. After blood tests and chest X-rays, he was diagnosed with mycoplasma pneumonia, which is a typical infectious respiratory disease—— Most of these diseases are caused by pathogens such as viruses, bacteria, mycoplasma, and chlamydia invading the respiratory mucosa. Mild cases such as the common cold, pharyngitis, and tonsillitis in the upper respiratory tract can be cured in a few days. If the pathogens invade the lower respiratory tract or even the lung parenchyma, they will develop into bronchitis and pneumonia, and in severe cases, they can induce respiratory failure.

Of course, not all respiratory problems are caused by foreign pathogens. Another type is caused by problems with the ventilation function of the airway itself, which is airway obstructive respiratory disease. I have an old patient, Uncle Zhang, who I have been following for almost 8 years. He has smoked for 32 years. In the past few years, he could still walk every day to buy groceries. In the past two years, he had to stop for half a day to catch his breath when he climbed to the second floor. Last year, he was diagnosed with moderate COPD through a lung function test. Long-term smoke stimulation causes repeated damage and proliferation of the airway mucosa. The originally smooth airway narrows, making it difficult to breathe in air, which is a typical obstructive airway problem. Asthma, which is more likely to occur when catkins and sycamore tree hairs are blowing in the spring, also falls into this category. The airways suddenly spasm and narrow after exposure to allergens. Many patients can't even speak coherently when they are sick, so they must always have emergency inhalants on hand.

There is another category that everyone is most vigilant about and that needs early screening the most, which is neoplastic respiratory diseases. I had seen a 42-year-old male programmer before, and he didn't feel any discomfort. However, during a low-dose CT scan in the unit, an 8mm ground-glass nodule was found on his lung. Further puncture biopsy confirmed that it was lung adenocarcinoma. Fortunately, it was discovered early, and after minimally invasive surgery, it basically did not affect his subsequent life. In addition to lung cancer, laryngeal cancer and malignant transformation of airway polyps also fall into this category. Most of them have no obvious symptoms in the early stage, and many people are already in the late stage when they are discovered. Therefore, high-risk groups who have been smoking for a long time, have a family history of cancer, and are exposed to oil fumes or dust all year round are best to have a low-dose chest CT screening every year.

Of course, this classification is not the only standard. Many clinical scholars tend to divide respiratory diseases into three categories: upper respiratory tract diseases, lower respiratory tract diseases, and interstitial pulmonary diseases according to the location of onset. There is no right or wrong distinction between the two classification methods, but they are only applicable in different scenarios. Classifying by location can help locate lesions faster during initial diagnosis at the grassroots level. When managing chronic diseases in respiratory specialists, classifying by cause makes it easier to formulate targeted treatment and follow-up plans.