支气管哮喘的发病机制、临床表现、诊断与治疗.ppt

支气管哮喘2021/5/27定义哮喘的病因及激发因素二、发病机制（三）气道高反应性(AHR)神经机制2021/5/27病理临床表现二、体征实验室和其他检查诊断支气管哮喘的分期及病情严重程度分级哮喘急发期：严重程度分级哮喘急性发作分度的诊断标准(1)哮喘急性发作分度的诊断标准(2)ClassificationofAsthmaSeveritybyClinicalFeaturesBeforeTreatmentIntermittentSymptomslessthanonceaweekBriefexacerbationsNocturnalsymptomsnotmorethantwiceamonth•FEV1orPEF≥80%predicted•PEForFEV1variability<20%MildPersistentSymptomsmorethanonceaweekbutlessthanonceadayExacerbationsmayaffectactivityandsleepNocturnalsymptomsmorethantwiceamonth•FEV1orPEF≥80%predicted•PEForFEV1variability<20–30%ModeratePersistentSymptomsdailyExacerbationsmayaffectactivityandsleepNocturnalsymptomsmorethanonceaweekDailyuseofinhaledshort-acting2-agonist•FEV1orPEF60-80%predicted•PEForFEV1variability>30%SeverePersistentSymptomsdailyFrequentexacerbationsFrequentnocturnalasthmasymptomsLimitationofphysicalactivities•FEV1orPEF≤60%predicted•PEForFEV1variability>30%哮喘慢性持续期的严重度分级鉴别诊断哮喘治疗中的问题治疗交感神经释放去甲肾上腺素三、急性发作期的治疗严重度Step1间歇发作严重度Step2轻度持续严重度Step3中度持续严重度Step4重度持续四、哮喘的长期治疗合理的哮喘治疗正常的健康生活