小气道病变与哮喘.ppt

* * References 1. Kraft M, et al. Alveolar tissue inflammation in asthma. Am J Respir Crit Care Med 1996;154:1505-10. 2. Kraft M, et al. Distal lung dysfunction at night in nocturnal asthma. Am J Respir Crit Care Med 2001;163:1551-6. 3. In ‘t Veen JC et al. Recurrent exacerbations in severe asthma are associated with enhanced airway closure during stable episodes. Am J Respir Crit Care Med 2000;161:1902-1906. 4. D’Amato G, et al. Outdoor air pollution, climatic changes and allergic bronchial asthma. Eur Respir J 2002;20:763-776. 5. Zeidler MR, et al. Small airways response to naturalistic cat allergen exposure in subjects with asthma. J Allergy Clin Immunol 2006;118:1075-1081. 6. Wagner EM, et al. Peripheral lung resistance in normal and asthmatic subjects. Am Rev Respir Dis 1990;141:584-8. 7. Hyde DM, et al. Anatomy, pathology, and physiology of the tracheobronchial tree: emphasis on the distal airways. J Allergy Clin Immunol 2009;124:S72-7. 8. Kaminsky DA, et al. Peripheral airways responsiveness to cool, dry air in normal and asthmatic individuals. Am J Respir Crit Care Med 1995;152:1784-90. * 小气道功能异常可能是夜间哮喘患者夜间症状增加的原因。 Reference Kraft M, et al. Distal lung dysfunction at night in nocturnal asthma. Am J Respir Crit Care Med 2001;163:1551-6. * 单次呼吸氮冲洗法检测出的闭合气量（CV）或闭合容量（CC）增加提示着小气道疾病。 重度哮喘中，这些参数的增加与重复性的哮喘发作相关。 Reference In ‘t Veen JC et al. Recurrent exacerbations in severe asthma are associated with enhanced airway closure during stable episodes. Am J Respir Crit Care Med 2000;161:1902-1906. * 与健康人相比，即使肺功能在正常范围内的中度哮喘患者小气道的阻力也是健康人的7倍 尽管对肺功能影响有限，这种小气道阻力的升高也会加剧哮喘的气道反应性。 References 1. Wagner EM, et al. Peripheral lung resistance in normal and asthmatic subjects. Am Rev Respir Dis 1990;141:584-8. 2. Hyde DM, et al. Anatomy, pathology, and physiology of the tracheobronchial tree: emphasis on the distal airways. J Allergy Clin Immunol 2009;124:S72-7. * 干冷空气刺激会增加中度哮喘患者的外周肺阻力。 The recruitment of small airways determines the severity of exercise-induced bronchoconstr