1、AirwayHyperresponsivenessPlasmaleakageMucus hypersecretionInflammatorycell recruitmentand activationNeural activationVirus-infected epitheliumNakano, Y. et al. Chest 2002;122:271S-a-275S-aPathophysiologic schema for the development of asthmaCopyright 3M Pharmaceuticals 2004Vignola, A. M. et al. Ches
2、t 2003;123:417S-a-422S-aIncreased thickness of the basement membrane (arrow), and enhanced and abnormal deposition of fibronectin, which is identified by immunohistochemistry using a specific monoclonal antibody (dashed arrow), in the bronchial submucosaIncreased thickness of the basement membrane ,
3、 and enhanced and abnormal deposition of collagen in the bronchial submucosaAirway inflammationAirflow obstructionBronchial hyperresponsiveness SymptomsSymptoms (episodic/variable)wheezeshortness of breathchest tightnesscoughSignsnone (common)wheeze diffuse, bilateral, expiratory ( inspiratory)tachy
4、pneaHelpful additional informationpersonal/family history of asthma or atopy history of worsening after aspirin/NSAID, blocker userecognised triggers pollens, dust, animals, exercise, viral infections, chemicals, irritantspattern and severity of symptoms and exacerbationsReliever:nInhaled beta agoni
5、st prnPEF: 80%PEF: 80%PEF: 60%PEF: 60-80%$Bronchodilators Relaxing bronchial smooth muscle to open up the airway. $Anti-inflammatory agents Inhibiting the development of airway inflammation and stopping ongoing inflammation. In combination, treat and prevent reversible airway obstruction and airway
6、hyperresponsiveness, relieve the symptom and decrease the exacerbation.$Long-term control medication (Controller) Corticosteriods Cromolyn/nedocromil Long acting 2 agonists(LABA) Leukotriene modifier$Quick relief medication (Rescuer) Short-acting 2 agonists Theophylline Anticholinergics Systemic Corticosteriods$Oxygen therapy and mechanical ventilation$Short-acting 2 agonists$Aminophylline$Anticholinergics$ Corticosteriods $Same as acute exacerbation of asthma$Fluid infusion$Modification of acidosis$Antibiotics$Maintenance of electrolyte balance$ Resolution of complications
