内科学英文课件：Bronchial asthma
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allergens,exercise,laughter, cold air • Symptoms often appear or worsen with viral
infection
Atypical asthma
• Cough or chest tightness • Cough-variant asthma: cough only • often at night or early in the morning • Triggered by exercise\cold air • Relieved with bronchodilators\ICS
哮喘的定义
• Allergic inflammation气道慢性变态反应性炎症 • Inflammatory cells由多种炎症细Hale Waihona Puke Baidu：如嗜酸粒细胞、肥大细胞、
T淋巴细胞、嗜中性粒细胞、 • Structural cells 气道结构细胞：平滑肌、气道上皮细胞等） • 细胞组分(cellular elements)参与的气道慢性炎症性疾病 • 慢性炎症导致气道高反应性（airway hypersensitivity） • 引起反复发作性的喘息、气急、胸闷或咳嗽等症状，常在夜间
• Variable airflow limitation • Both symptoms and airflow limitation vary over time
and in intensity • Triggers: exercise, allergen, irritant exposure, change in
weather, viral respiratory infection • Resolution spontaneously or with medication • Airway hyperresponsiveness and inflammation
persists, even when symptoms are absent/normal lung function
规律： ▪ 节律性(夜间发作) ▪ 季节性(春、秋) ▪ 自然/用药缓解
▪ 体征 ▪ 呼气时产生哮鸣
音
Cardinal feature of asthma
• Variable symptoms of wheeze, shortness of breath, chest tightness and/or cough
Bronchial asthma
支气管哮喘
Those to be remembered
Morbidity of asthma
Mortality of asthma
• 在中国有1500万，全球3亿哮喘患者，每100，000位哮喘患者中有36.7
位哮喘患者会因哮喘死亡。
Definition
• Asthma is a heterogeneous disease, characterized by chronic airway inflammation. It is defined by history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary in time and intensity, together with variable expiratory flow limitation.
Pathogenesis of asthma
环境因素
遗传易感个体
炎症细胞、细胞因子 及炎症介质相互作用
气道神经调节失衡 及气道平滑肌结构功能异常
气气道 道炎 炎症 症 气道重建
气道高反应性 环境激发因子
症状性哮喘
Cardinal manifestations-typical
喘息
呼吸困难
咳嗽
诱发因素： ▪ 活动后 ▪ 吸入冷空气后 ▪ 夜间 ▪ 感冒后 ▪ 突然发作性
和（或）清晨发作、加剧 • 通常出现广泛多变的可逆性气流受限， • 多数患者可自行缓解或经治疗缓解
Pathogenesis
• Genetic factors • Airway immunity-inflammation
Allergic response-early asthmatic and late asthmatic response airway hyperresponsiveness airway remodelling • Neurologic accomodation
Cardinal manifestations
• Generally more than 2 types of symtoms • Symptoms occur variably over time and vary
in intensity • Symptoms are worse at night or on waking • Symptoms are often triggered by
特殊类型哮喘
• Exercise-induced asthma • Aspirin asthma：asthma,nasal polyp and
aspirin intolerance • Asthma-COPD overlap syndrome
Asthma TRIGGERS
ENVIRONMENTAL FACTORS Allergens • Indoor: Domestic mites, furred animals (dogs, cats, mice),
cockroach allergen, fungi, molds, yeasts • Outdoor: Pollens, fungi, molds, yeasts Infections (predominantly viral) Exercise Drugs: aspirin Diet: fish, milk, egg, prawn, crab Psychiatric Occupational sensitizers
infection
Atypical asthma
• Cough or chest tightness • Cough-variant asthma: cough only • often at night or early in the morning • Triggered by exercise\cold air • Relieved with bronchodilators\ICS
哮喘的定义
• Allergic inflammation气道慢性变态反应性炎症 • Inflammatory cells由多种炎症细Hale Waihona Puke Baidu：如嗜酸粒细胞、肥大细胞、
T淋巴细胞、嗜中性粒细胞、 • Structural cells 气道结构细胞：平滑肌、气道上皮细胞等） • 细胞组分(cellular elements)参与的气道慢性炎症性疾病 • 慢性炎症导致气道高反应性（airway hypersensitivity） • 引起反复发作性的喘息、气急、胸闷或咳嗽等症状，常在夜间
• Variable airflow limitation • Both symptoms and airflow limitation vary over time
and in intensity • Triggers: exercise, allergen, irritant exposure, change in
weather, viral respiratory infection • Resolution spontaneously or with medication • Airway hyperresponsiveness and inflammation
persists, even when symptoms are absent/normal lung function
规律： ▪ 节律性(夜间发作) ▪ 季节性(春、秋) ▪ 自然/用药缓解
▪ 体征 ▪ 呼气时产生哮鸣
音
Cardinal feature of asthma
• Variable symptoms of wheeze, shortness of breath, chest tightness and/or cough
Bronchial asthma
支气管哮喘
Those to be remembered
Morbidity of asthma
Mortality of asthma
• 在中国有1500万，全球3亿哮喘患者，每100，000位哮喘患者中有36.7
位哮喘患者会因哮喘死亡。
Definition
• Asthma is a heterogeneous disease, characterized by chronic airway inflammation. It is defined by history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary in time and intensity, together with variable expiratory flow limitation.
Pathogenesis of asthma
环境因素
遗传易感个体
炎症细胞、细胞因子 及炎症介质相互作用
气道神经调节失衡 及气道平滑肌结构功能异常
气气道 道炎 炎症 症 气道重建
气道高反应性 环境激发因子
症状性哮喘
Cardinal manifestations-typical
喘息
呼吸困难
咳嗽
诱发因素： ▪ 活动后 ▪ 吸入冷空气后 ▪ 夜间 ▪ 感冒后 ▪ 突然发作性
和（或）清晨发作、加剧 • 通常出现广泛多变的可逆性气流受限， • 多数患者可自行缓解或经治疗缓解
Pathogenesis
• Genetic factors • Airway immunity-inflammation
Allergic response-early asthmatic and late asthmatic response airway hyperresponsiveness airway remodelling • Neurologic accomodation
Cardinal manifestations
• Generally more than 2 types of symtoms • Symptoms occur variably over time and vary
in intensity • Symptoms are worse at night or on waking • Symptoms are often triggered by
特殊类型哮喘
• Exercise-induced asthma • Aspirin asthma：asthma,nasal polyp and
aspirin intolerance • Asthma-COPD overlap syndrome
Asthma TRIGGERS
ENVIRONMENTAL FACTORS Allergens • Indoor: Domestic mites, furred animals (dogs, cats, mice),
cockroach allergen, fungi, molds, yeasts • Outdoor: Pollens, fungi, molds, yeasts Infections (predominantly viral) Exercise Drugs: aspirin Diet: fish, milk, egg, prawn, crab Psychiatric Occupational sensitizers