课件：抗胆碱能药物在治疗中的地位.ppt

思力华包装 18μg*10粒胶囊+吸乐装置 18μg*10粒胶囊 首次处方推荐： （10粒胶囊+吸乐）*1盒+10粒胶囊*2盒 复诊处方推荐： 10粒胶囊*3盒 思力华进入医保目录 思力华在2009年进入国家医保目录 我省医保目录2010年*月*日开始执行,思力华可以报销 谢 谢! 感谢您参加“思力华活力明天”科室会 看看哪位老师是今天最幸运的一位 后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析 * * * COPD的发病机制包括2种通路，气道炎症通路和迷走通路 在COPD中，烟草以及其他吸入型刺激性物质均可诱发炎症反应。COPD炎症反应以中性粒细胞为主，导致气道粘液过度分泌和肺泡壁损伤。 同时，吸烟可以刺激迷走神经引起乙酰胆碱释放，导致平滑肌收缩、气道痉挛、气道粘液过度分泌。 * 这张图形象地展示了乙酰胆碱是如何导致起到痉挛和粘液分泌过多的。 吸烟等有害物质的刺激导致上皮细胞受损脱落，迷走神经末梢暴露，反射到中枢神经导致迷走神经释放神经递质乙酰胆碱，从而使平滑肌收缩、气道痉挛、气道粘液过度分泌。 * In COPD, irreversible damage causes the alveolar walls and supports to lose elasticity compared with the normal condition. The airways are partly collapsed and occluded, an effect made worse by reversible cholinergic constriction.1 As a result, deflation is slower, and so the alveolus only partly deflates over the course of an exhalation. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. 2001. /workshop/toc.html. Accessed: 14 November 2003. * COPD patients suffer from reduced expiratory flow. As a result, the lungs may not fully empty before the next breath begins. This is particularly likely if the patient has to breathe faster as a result of physical activity.1 Because the lungs do not fully empty, they become progressively over inflated with each breath. This process is known as air trapping, which leads to hyperinflation.1 Air trapping reduces the ability of the patient to breathe in, which causes the sensation of breathlessness that typifies the disease. ODonnell DE, Webb K. The etiology of dyspnea during exercise in COPD. Pulmonary and Critical Care Update 14, Lesson 15./downloads/education/online/Vol14_13_18.pdf. Accessed 24 February 2004. * 1Cooper CB. The connection between chronic obstructive pulmonary disease symptoms and hyperinflation and its impact on exercise and function. Am J Med 2006; 119:S21-S31 2Casanova C, Cote C, de Torres