《炎症反应的双通道》PPT课件.ppt

Slide 1 哮喘症状由尚未被控制的气道炎症所致 炎症反应的双通道 Slide 2 Adapted from National Institutes of Health Global Initiative for Asthma: Global Strategy for Asthma Management and Prevention: A Pocket Guide for Physicians and Nurses. Publication No. 95-3659B. Bethesda, MD: National Institutes of Health, 1998; Bjermer L Respir Med 2001;95:703-719. 炎症反应在哮喘中的重要性 n哮喘本质上是一种炎症反应疾病 n炎症反应导致气管收缩及气道高反应性，从而 产生症状 n对轻中度哮喘病人应首先进行控制炎症的治疗 Slide 3 抑制多种炎症介质 细胞因子 粘附分子 可诱导的酶 对炎性反应的多种作用 Adapted from Peters-Golden M, Sampson AP J Allergy Clin Immunol 2003;111(suppl 1):S37-S48. 炎症反应的双通道 皮质激素的作用 Slide 4 尽管使用了吸入激素，气道炎症仍持续存在 ICS=inhaled corticosteroids; OCS ICS=received oral corticosteroids with or without ICS Adapted from Louis R et al Am J Respir Crit Care Med 2000;161:9-16. 20,000 10,000 1,000 100 10 1 Eosinophil 103/g sputum Control group 轻轻到中度哮喘 ICS low-dose (n=10) ICS high-dose (n=15) OCS (n=10) OCS ICS (n=7) 重度哮喘 p0.05 vs. 基线) P=0.011 11. Bjermer L, Bisgaard H, Bousquet J, et al. Montelukast and fluticasone compared with salmeterol and fluticasone in protecting against asthma exacerbation in adults: one year, double blind, randomised, comparative trial. BMJ. 2003;327:891895. Slide 25 IMPACT 研究 顺尔宁(孟鲁司特钠)+氟替卡松-不良事件发 生率显著低于沙美特罗+氟替卡松 74% P=0.01 61% P=0.02 6.3% 10.0% 4.6% 7.4% 11. Bjermer L, Bisgaard H, Bousquet J, et al. Montelukast and fluticasone compared with salmeterol and fluticasone in protecting against asthma exacerbation in adults: one year, double blind, randomised, comparative trial. BMJ. 2003;327:891895. Slide 26 半胱氨酰白三烯和对类固醇敏感的介质是哮喘 炎症反应中的两条通道 激素不能阻断半胱氨酰白三烯介导的炎症通路 同时作用哮喘病人气道炎症的两条通路，可以 达到更好的炎症控制及哮喘控制 Adapted from Peters-Golden M, Sampson AP J Allergy Clin Immunol 2003;111(1 suppl)