BronchialAsthma支气管哮喘-PPT文档.ppt
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1、简 介,哮喘是一种全球性的慢性疾患 全球:逾3亿哮喘患者 我国:逾2千万哮喘患者 儿童:患病率0.11%2.03% 哮喘患病率及死亡率仍有上升趋势,G IN A,lobal itiative for sthma,GINA,简 介,简 介,世界哮喘病日 World Asthma Day,World Asthma Day 2005: The Unmet Needs of Asthma World Asthma Day is an annual event organized by the Global Initiative for Asthma (GINA) to improve asthma a
2、wareness and care around the world. World Asthma Day 2005 will take place on May 3.,A winner of the Bangladesh Asthma Associations 2004 “Healthy Home; Healthy Lungs“ art contest receives a prize.,哮喘: 是以气道内炎症、 反应性增加(同时气道对通常称 为哮喘诱发因素 的各种过敏原) 的为特点的一种慢性呼吸道疾病。,气道慢性炎症 可逆性的气道阻塞/气流受阻,正常的支气管黏膜,异常的支气管黏膜,Defin
3、ition of Asthma,Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role Chronic inflammation leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning,Definition of Asth
4、ma,支气管哮喘是由多种炎性细胞参与的气道慢性炎症。 哮喘的本质是气道慢性变应性炎症,Inflammation,Cells: eosinophil, mast cell, T cell (Th2), B cell, basophil, neutrophil and resident cells such as epithelial cells and fibroblasts,Infection,粘液分泌过多,嗜酸性细胞,肥大细胞,抗原,Th2 细胞,血管扩张 新血管形成,血浆渗出 水肿形成,中性粒细胞,粘 液 栓,巨噬细胞/ 树突状细胞,平滑肌收缩肥大 / 增生,胆碱能反射,上皮脱落,上皮纤维
5、化,感觉神经激活,神经激活,哮喘的发病机制和病理改变,Ag,Cells,Cellular elements,Reaction,airway chronic inflammation / airway hyperresponsive /airflow obstruction,有了哮喘的人会出现什么情况?,什么情况自行管理? 什么情况应立即到医院?,什么情况应立即到医院?,哮喘发作是指病人反复出现加重的气短、咳嗽、喘鸣、胸闷或其中的部分症状。 哮喘病情有轻有重,严重者危及生命。,Acute on chronic allergic inflammation,慢 性 炎 症(allergic infl
6、ammation),结构改变,急性发作:短效2激动剂,哮喘病程,Barnes PJ,ICSLABA缓释茶碱,慢性炎症:ICS,什么情况自行管理?,哮喘的发病机制,急性发作期和缓解期哮喘气道内均存在嗜酸性细胞、肥大细胞和中性粒细胞等炎症细胞浸润,气道变应性炎症 (airway allergic inflammation) InflammationInfection,Asthma Diagnosis (咳嗽变异性哮喘),不喘的哮喘 咳嗽为唯一症状 又称咳嗽变异性哮喘 (过敏性咳嗽),Asthma Diagnosis,您有咳嗽、喘息和胸闷症状吗? 您有因咳嗽、喘息和胸闷而夜间憋醒吗? 您有因咳嗽、喘
7、息而不能参加运动吗? 您有因咳嗽、喘息而误工误学吗? 您有使用平喘药后咳、喘症状缓解的历史吗?,30秒钟诊断自测题,Asthma Diagnosis,Symptoms Measurements of lung function,治疗哮喘方法有哪些?,药物是控制哮喘的唯一方法吗?,不是。避免使气道致敏、发炎、使哮喘恶化的刺激物是很重要的,这些东西叫哮喘触发因素,每个患者都必须知道自己应该避免的触发因素。,Asthma Treatment,Part 4: Establish medication plans for long-term asthma management,GINA,Part 1:
8、Educate patients to develop a partnership in asthma management,Part 2: Assess and monitor asthma severity with measurements of symptoms and measurements of lung function,Part 3: Avoid exposure to risk factors,Part 5: Establish plans for managing exacerbations,Part 6: Provide regular follow-up care,强
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