文档介绍：BronchialasthmaDepartmentofrespirationKongLingfeiAsthma:humankiller!BackgroundofasthmaPrevalence:intheworld::1~3%inShenyang:%(1999)GINA:GlobalInitiativeforAsthma(1994)WHO/HLBIBronchialasthmaticdiagnosisguideline(1997)ChineseMedicalAcademyDefinitionsofasthmaChronicairwayinflammationBroncho-hyperresponsiveness,BHRAirflowlimitationMechanism:allergytheoryantigenantigen↓↓againatopy→IgEantibody→mastcells,basophils↓histamineinflammatorymediaLTs↓PAFECPimmediateasthmaticreaction,IAR↓bronchialsmoothmusclespasmairwaynarrowMechanism:never-eroussystems,ACnon-adrenergicandnon-eroussystems,NANCAC:α1-receptor、M1-、M3-receptorsexcitementNANC:PS-receptor↓bronchialsmoothmusclecontractionAC:β-receptor、M2-receptorexcitementNANC:VIPreceptor↓bronchialsmoothmuscledilationasthmaticairway:a1、M1、M3、PS↑/β、M2、VIP↓Mechanism:airwayinflammationtheoryantigen↓allergicairwayinflammation,AAIECP↑MBPinflammatorycells→inflammatorymediaLTsEOS↓PAFneutrophilslateasthmaticreaction,LARTlymphocyte(Th1/Th2↓)↓Th2cytokineIL-3、4、5,GM-CSF→IgE↑acuteinflammationchronicinflammationairwayremodellinginflammationcells↑epitheliuminjurybronchialcontractionmucousedemaairwaysecretion↑airwaynarrowBHR↑airwayreversibility↓symptomsexacerbationcellproliferationexcellularbase↑DiffermechanismsinacuteandchronicasthmaOthermechanisms:inducedfactorsAllergen:pollen,acarusinfection:virusormycoplasmalinfectionclimateandphysicalandchemicalfactorsdrugs:aspirininducedasthma,AIAβ-receptorinhibitorheredityGastroesophagealrefluxdisease,GERDPsychological,incretionfactors,sportsDiagnosisstandardsofasthmasymptomssignsrecoveredwaysexceptothercardiacandpulmonarydiseaseslungfunctionexamination→untypicalasthma