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1、BronchialAsthmaIntroductionBronchialasthmaachronicinflammatoryconditioninvolvingavarietyofcellsincludingeosinophils,mastcells,Tlymphocytes,neutrophils,andepithelialcellsoftheairway,aswellascellularelementswhichgivesrisetotheincreaseofairwayhyper-reactivity.Extensivechangeabl
2、eandreversibleventilationrestrictioniscommonCauserecurrenttachypnea,feelingofoutofbreath,andcoughingThesymptomsaremoreusuallypresentandaggravatedatnightorearlyinthemorningRemissionmightbeachievedspontaneouslyorfollowingtreatmentEpidemiology160millionpatientsintheworldprevale
3、nce：1%--5%，0.5-1%inchinaPrevalenceinmaleissimilartothatinfemaleTheonsetisbefore12yearsofageinthemajorityFamilyhistorycouldbefoundin20%patientsRelatedtoallergicrhinitis,eczemaandnasalpolypEtiologyThepathogenesisofasthmaiscomplicatedAffectedbygeneticsandtheenvironmentItisamult
4、igenedisorderandcloselyrelatedtoatopyMostpatientshavepriorhistoryofeczema,allergicrhinitis,foodordrugallergy,andquiteafewpatientshavefamilyhistoryTheformationandattackofasthmaisalsoaconsequenceofthefunctionofmultipleenvironmentalfactorssuchasinhalationofallergens,respiratory
5、tractvirusinfection,andcoldnessEtiology１．Geneticfactors:multigeneinheritanceheritability70-80%２．Predisposingfactors:airpollution1）inhalants：dustmites、pollen2）infections3）food4）changeofweather5）mentalfactors6）exercise7）drugs8）menstruation,pregnacyPathogenicmechanismAsthmaisCh
6、aracteristicofhyper-reactivityoftheairwayChronic（allergic）inflammationisthebasiclesionofasthmaAllergicinflammationInvestigationshaveshownthatallergicreactionslikeasthmaaremediatedbyTh2cells.ThereisanincreaseorpredominanceofTh2oritscytokines.Theresultingairwayinflammationcoul
7、dbeclassifiedintothefollowingtwotypes:1.IgEmediatedandTlymphocytedependentpathway2.NonIgEmediatedandTlymphocytedependentpathwayImmunologicfactorsTheroleofIgEmediationThecombinationofallergenwithspecificIgEtriggersthedegranulationofthemastcellsandeosinophils,resultinginreleas
8、eofmediatorsincludingleukotrienesC,D,E,andthesubsequentsmoothmusclecontract
