课件：支气管哮喘ly.ppt

* Slide 5 Both the early- and late-phase asthmatic responses are characterized by allergen-induced release of cysteinyl leukotrienes from inflammatory cells, such as mast cells, eosinophils, basophils, macrophages, and monocytes.1-3 Cysteinyl leukotrienes (LTC4, LTD4, LTE4) contribute to the airflow obstruction, hyperreactivity, and inflammatory exudates in the asthmatic airway through four main mechanisms:3 ? Eosinophil recruitment into the airways, which is considered an important  event in the asthmatic process.1 Eosinophil infiltration is associated with epithelial damage and increased airway responsiveness.4 ? Increase in microvascular permeability, leading to exudation of plasma into  the airway wall and lumen and the formation of edema.5 ? Increased secretion of mucus, which interacts with plasma protein and cell debris to form mucous plugs.5 ? Marked bronchoconstriction, produced by contractile effects on the smooth muscle within airway walls.5 Cysteinyl leukotrienes may also contribute to airway smooth- muscle hypertrophy and remodeling.1 1. Hay DWP, Torphy TJ, Undem BJ. Cysteinyl leukotrienes in asthma: Old mediators  up to new tricks. Trends Pharmacol Sci 1995;16:304-309. 2. Pauwels RA, Joos GF, Kips JC. Leukotrienes as therapeutic target in asthma. Allergy  1995;50:615-622. 3. Spector SL. Leukotriene inhibitors and antagonists in asthma. Ann Allergy 1995;75(6):463-474. 4. Bj?rnsdottir US, Quan SF, Busse WW. Eosinophils and asthma. In: Busse WW, Holgate ST, eds. Asthma and Rhinitis. Cambridge, MA: Blackwell Science, 1995:328-346. 5. Holgate ST, Bradding P, Sampson AP. Leukotriene antagonists and synthesis inhibitors:  New directions in asthma therapy. J Allergy Clin Immunol 1996;98(1):1-13. * * 目前市场上吸入装置的种类。 * 气雾剂的优点与不足 * 干粉剂剂的优点与不足 * * 照读。 * 常用吸入剂 喷射雾化器 pMDI的优点和不足 Jackson, 1995 使用快捷 携带方便 多剂量装置 价格便宜 吸入技巧要求高，病人不易掌握 需要抛射剂，易引起病人呛咳 口咽部沉积量高，局部及全身副作用大 受极端温度影响大 优点 不足 DPI(干粉剂 )的优点和不足 Jackson, 1995 与pMDI相似的优点  不需抛射剂，不会对病人产生刺激 吸