支气管哮喘-7制级.ppt

7.解痉平喘药物有哪些? 包括: 速效β2受体激动剂(首选)、 抗胆碱能药物、 甲基黄嘌呤类、 全身应用的糖皮质激素. 8.抗炎止喘药物有哪些? 包括:吸入型糖皮质激素(首选) 吸入型长效β2受体激动剂(LABA) 白三烯调节剂 甲基黄嘌呤类 色甘酸二钠 全身糖皮质激素口服减量疗法 9.糖皮质激素治疗哮喘的机制是什么? ? 抑制炎症细胞的迁移和活化； ? 抑制细胞因子的生成； ? 抑制炎症介质的释放； ? 增强平滑肌细胞β2受体的反应性。 10.重度哮喘发作的治疗原则有哪些? (1) 解痉平喘药的使用。 ⑵??氧疗,使氧分压＞60mmHg.  ⑶??纠正水电解质酸碱平衡紊乱。 适当补液。当pH值7.20，且合并 代谢性酸中毒时，应适当补碱。 (4) 抗生素 ⑸ 并发症的处理 * 新近由GINA出版的“全球哮喘疾病负担”的报告中指出中国的哮喘患者死亡率极高，约每100,000位哮喘患者中有36.7位患者会因哮喘死亡，而加拿大仅为1.6位哮喘患者。另外，中国农村地区哮喘患者死亡率是城市的2倍。 * 包括哮喘易感基因、过敏体质等 * 包括过敏原（室内外、食物）、职业暴露（油漆等）、某些激发因素 * * Asthma is a complex disease involving many different cells Current thinking on the pathophysiology of asthma regards it as a specific type of inflammatory condition, involving, in particular, mast cells, eosinophils and T lymphocytes, which release a wide range of inflammatory mediators These mediators act on cells in the airway, leading to contraction of smooth muscle, oedema due to plasma leakage and mucus plugging * Slide 6 - The pathophysiogical consequences of airway inflammation is remodelling and airway narrowing, increased bronchial reactivity and reduced reversibility. This leads to the clinical manifestations of the disease - intermittent symptoms and prolonged periods of exacerbations. * 哮喘症状是“冰山的一角” 平时我们所看到患者哮喘症状，只是哮喘疾病的这座冰山露出水面的那一小部分。水面下的部分才是哮喘真正的病因，更大更危险。所以，哮喘治疗不能仅对症，更要对因。 * * * * 哮喘的炎症发展过程是一种慢性进行性的病变。 * Adult – current treatment strategies III A stepwise approach to treatment is recommended in asthma guidelines, which have been developed by International Asthma bodies (GINA) and endorsed by national healthcare committees. The treatment follows a managed care approach and should be ‘stepped up’ as necessary to achieve control of asthma. Treatment should be tailored to the needs of the individual patient and reviewed regularly. Once control has been achieved, a gradual step-down should