149例支气管哮喘病因分析

支气管哮喘是由多种细胞(如嗜酸性粒细胞、肥大细胞、T淋巴细胞、嗜中性粒细胞、气道上皮细胞等)和细胞组分参与的气道慢性炎症性疾患。这种慢性炎症导致气道高反应的增加,并     

哮喘近年来的药物治疗现状

支气管哮喘（bronchi alasthma,简称哮喘）是由多种细胞（如嗜酸性粒细胞、肥大细胞和T淋巴细胞、中性粒细胞、气道上皮细胞等）和细胞组分参与的气道慢性炎性疾病。这种慢性炎性反应导致气道反应性增加,通常出现广泛多变的可逆性气流受限,并引起反复发作性的喘息、气急、胸闷或咳嗽等症状,常在夜间和（或）清晨发作、加剧,多数患者可自行缓解或经治疗缓解。哮喘治疗目的在于减少发作,改善呼吸功能,防止气道组织增厚与狭窄。现对哮喘近年来药物治疗方法综述如下。     

支气管哮喘药物治疗进展

支气管哮喘(bronchial asthma,简称哮喘)是一种有嗜酸性粒细胞(Eos)、肥大细胞和T淋巴细胞等多种炎症细胞参与的气道慢性炎症.这种炎症使易感染者产生气道高反应性,表现为喘息反复发作、呼吸困难、胸闷或咳嗽等症状,常在夜间和(或)清晨发作、加剧,伴有广泛多变的可逆性气流受限,多数患者可自行或经治疗后缓解.哮喘治疗目的在于减少发作、改善呼吸功能,防止气道组织增厚与狭窄.抗炎、对症、免疫治疗被认为是支气管哮喘最基本的治疗方法[1],此外,尚有多种方法,现综述如下.     

支气管哮喘的药物治疗

支气管哮喘是由嗜酸性粒细胞、肥大细胞和T淋巴细胞等多种炎性细胞参与的气管慢性炎症,诱发因素多种多样,有些机制尚不清楚,因此各种药物的作用环节不同。现就支气管哮喘的药物治疗综述如下。     

抗哮喘药物临床应用现况简介

支气管哮喘（以下简称哮喘）是由多种细胞（如嗜酸性粒细胞、肥大细胞、淋巴细胞、嗜中性粒细胞、气道上皮细胞等）和细胞组分参与的气道慢性炎症性疾病。这种慢性炎症导致气道高反应性的增加，通常出现广泛多变的可逆性气流受限，并引起反复发作性的喘息、气急、胸闷或咳嗽等症状，常在夜间和（或）清晨发作、加剧，多数患者可自行缓解或经治疗缓解。现有的常用药物有＆受体激动剂、M胆碱受体拈抗剂、磷酸二酯酶抑制剂、肾上腺皮质激素、抗自三烯药物等，笔者参考有关文献对抗哮喘药物作简单的介绍。     

酚妥拉明联合硫酸镁治疗重症支气管哮喘

支气管哮喘是一种多发病和常见病,主要由多种细咆(如嗜酸性粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、气道上皮细胞等)和细胞组分参与的气道慢性炎症性疾病。大多数专家认为此病与基因遗传有关,同时受遗传因素和环境因素的双重影响。目前对于支气管哮     

支气管哮喘90例治疗分析

支气管哮喘是一种反复发作的呼吸系统疾病,主要由于嗜酸性粒细胞、肥大细胞和T淋巴细胞等多种炎性反应细胞,激发气道的高反应性,从而导致气道狭窄。本研究对90例支气管哮喘患者的治疗情况进行观察。现报告如下。     

哮喘相关炎性细胞作用机制的研究进展

支气管哮喘是世界范围内严重威胁公众健康的主要慢性疾病之一,粗略估计我国有1600万～2000万[1]哮喘患者。哮喘是由多种细胞(如嗜酸性粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、气道上皮细胞等)和细胞组分参与的气道慢性炎症性疾病。这种慢性炎症导致气道对外界抗原刺激的反应性增加,并引起反复发作的喘息、气急、胸闷或咳嗽等症状。本文就哮喘相关的炎性细胞作用机制做一简要论述。1嗜酸性粒细胞近年的研究表明[2],哮喘患者气道慢性炎症的特征性表现为浸润到气道的嗜酸性粒细胞(EOS)及淋巴细胞增多,传统理论上认为EOS主要作为“终末阶…     

雾化吸入治疗小儿支气管哮喘的护理体会

支气管哮喘是由多种细胞(如嗜酸性粒细胞、肥大细胞及气道上皮细胞等)和细胞成分共同参与的气道慢性炎症[1]。本文主要对我科收治的支气管哮喘患儿,护士配合医生治疗在雾化吸入方面的护理措施,使哮喘急性发作及早得到缓解的经验进行归纳和总结。1临床资料2004年2月～2007年2月,     

支气管哮喘药物治疗近况

支气管哮喘是多种细胞（嗜酸性粒细胞,肥大细胞,淋巴细胞,中性粒细胞,气道上皮细胞）和细胞组分参与的气道慢性炎症性疾病。这种慢性炎症导致气道高反应性,临床表现为反复发作并伴有哮鸣音的呼气性呼吸困难．胸闷或咳嗽。诱发因素多种多样。目前药物治疗仍是支气管哮喘治疗的首要方法,其防治的常用药物包括肾上腺皮质激素,茶碱类,肾上腺素受体激动剂,     

哮喘治疗合理用药问答

1 吸入激素不良反应的风险有多高？ 国内支气管哮喘患者大多对吸入激素还存在一些顾虑,主要原因是担心吸入激素后会与口服或者注射用激素一样产生许多不良反应。事实上,由于吸入激素直接作用于病变部位,而且吸入量往往为口服或静脉用量的几十分之一,吸入后药物进人血液全身循环的剂量就更低,极少发生不良反应。许多患者规则地吸入激素长达数年之久,亦未发现明显不良反应。少数患者吸入激素一段时间后出现咽痒、声嘶,这是因为吸入药物后没有按规定认真漱口,药物沉积在咽后壁上造成的,故每次吸药后要用清水认真漱口,以清除口咽部残余的药物。     

茶碱类药物在哮喘治疗中的应用

近年研究表明,小剂量茶碱有抗炎、免疫调节和扩张支气管等多方面的作用,与吸入糖皮质激素联用有协同抗炎、改善肺功能的作用。     

哮喘患者长期使用哮喘控制药物的安全性调查

目的调查哮喘患者长期使用哮喘控制药物的安全性。方法对2009年7月至12月在复旦大学附属中山医院哮喘门诊规范使用哮喘控制药物超过3 mo的患者的基本情况、既往用药信息及药物不良反应(ADR)进行调查。检测20例每日坚持使用吸入糖皮质激素(ICS),疗程超过12 mo的哮喘患者的骨密度(BMD),并比较不同ICS日剂量和累积量患者的BMD。结果共收集200例患者,ADR发生率7.5%(15/200),主要表现为声音嘶哑、喉痛、头痛、心悸、肌颤、口腔念珠菌感染。ICS≥800μg·d~(-1)者与ICS<800μg·d~(-1)者之间的BMD比较无显著差异(P>0.05),ICS累积用量≥600 mg组患者腰椎和股骨粗隆BMD低于ICS<600 mg组患者(P<0.05)。结论长期使用哮喘控制药物总体是安全的,长期使用ICS的哮喘患者随着ICS累积量的增加,骨质丢失的危险性可能会增高。     

支气管哮喘治疗新药的开发及临床应用

支气管哮喘是临床常见的慢性气道炎症性疾病,尽管大部分哮喘患者可从支气管哮喘规范化治疗方案中获益,但仍有部分哮喘患者症状难以控制并持续加重。近年来随着哮喘发病机制的深入研究,哮喘临床冶疗取得了较大进展和突破,很多新药的出现为哮喘的治疗提供了更多的选择。本文综述支气管哮喘治疗新药的开发和临床应用评价。     

Investigation into use of drugs preceding death from asthma

Copies of death certificates were provided by the Registrar General for all deaths attributed to asthma in persons aged 5 to 34 years which were registered in England and Wales in the last quarter of 1966 and the first quarter of 1967. Information was obtained from the relevant general practitioners about 177 of the 184 subjects, and necropsy data were obtained for 113 of the 124 cases in which a post-mortem examination was known to have been made. Ninety-eight per cent. of the subjects for whom evidence was obtained were known to have been suffering from asthma, and signs of severe asthma (overdistended lungs and small bronchi plugged with mucus) were found in 91% of necropsies (57% of all deaths). Evidence that death might have been due to any other pathological condition was rare. Death was sudden and unexpected in 81% of the subjects (137 out of 171), and 59% of all deaths were referred to coroners. In 39% of cases (67 out of 171) the practitioner had not regarded the patient as suffering from severe asthma in his terminal episode. Corticosteroids and sympathomimetic preparations were the only drugs to have been used by a large proportion of patients. Two-thirds of the patients had received corticosteroids before the terminal episode, but detailed information about their use provided no suggestion that excess use could have been responsible for any large proportion of the deaths. Eighty-four per cent. of the patients were known to have used pressurized aerosol bronchodilators, and several instances of their use in excess were described. Routine inquiries about their use in the hours immediately preceding death were not made, and further evidence is required before their effect can be assessed adequately.     

Trends in pharmacogenomics of drugs used in the treatment of asthma.

Pharmacogenetic studies of drugs used in the treatment of asthma have produced a few examples of reduced response in patients carrying specific genotypes in genes involved in the action of beta-2 agonists or leukotriene modifiers. Other candidate genes related to these drugs, as well as glucocorticoids, theophilline, anticholinergics, antihistaminics, and drug-metabolizing enzymes, may be proposed. Statistical power and population stratification may be issues of importance in case-control association studies. Future developments include expanded gene knowledge from asthma genetic and genomic studies, the development of new preventive and curative treatments, multiple contemporary genotyping methods for pharmacogenetically important genes in a given individual, and the construction of asthma functional pharmacogenomic profiles. In conclusion, it seems that asthma pharmacogenetic studies need to be replicated in prospective clinical trials in different populations with a large number of subjects being genotyped. It is suggested that large clinical trials which are proposed for asthma drugs experimentation should include a pharmacogenetic study as well.     

The use of leukotriene modifying drugs in asthma and other respiratory diseases

Only rarely in modern medicine is an entirely new class of drug developed. Recently, a number of drugs that act as leukotriene modifiers (LTM's) have been licensed for use in the treatment of asthma. Airway obstruction in asthma has two key components--bronchoconstriction of airway smooth muscle and airway inflammation. Although a number of mediators are involved in this process, it has been demonstrated that leukotrienes can precipitate both. Leukotrienes are formed in eosinophils, mast cells and neutrophils. LTM's have been shown to attenuate bronchial hyper-reactivity and reduce chemotaxis of inflammatory cells in the asthmatic airway. This article reviews the data from clinical trials of LTM's, discusses their role in asthma therapy and postulates on use in other common respiratory diseases.     

吸入给药治疗哮喘中的不合理用药

吸入给药是哮喘治疗的一种基本的给药方式。吸入给药可直接作用于靶器官,起效快、给药剂量小、毒副作用少。目前常用的吸入装置主要有四种：定量压力气雾剂、定量压力气雾剂＋储雾罐、干粉吸入器和射流雾化器（Nebulizer）。应根据病情和病人的特点选择适当的药物和吸入装置。在临床实践中发现存在一些不合理应用的现象,需要引起临床医师和临床药师的注意。