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白三烯拮抗剂在儿童过敏性疾病的应用ppt课件

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白三烯拮抗剂在儿童过敏性疾病的应用 拮抗剂 在儿童 拮抗剂在儿童 的应用在儿童 应用ppt课件
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This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 白三白三烯烯烯烯受体拮抗受体拮抗剂剂剂剂治治疗疗疗疗儿童儿童过过过过 敏性疾病的作用和地位敏性疾病的作用和地位 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 内容摘要 • 过过敏性疾病的概述 • 白三烯烯受体拮抗剂剂的作用和地位 --白三烯烯受体拮抗剂剂在儿童哮喘 --运动诱发动诱发 哮喘 --婴婴幼儿喘息 --慢性咳嗽 --白三烯烯受体拮抗剂剂在儿童过过敏性鼻炎 --白三烯烯受体拮抗剂剂在儿童皮炎 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 过过敏性疾病概况 • 过过敏性疾病定义义: – 由过过敏原引起,IgE介导导的全身性免疫功能紊乱 – 其主要靶器官:鼻、肺/支气管、皮肤; • 过过敏性疾病的流行病学: – 发发展迅速:过过去20年成3倍增长长;SAR(在英国)20 -30%; • 原因:空气污污染、工业发业发 达化 BMJ. 2000;321:88-92. Clin Exp Allergy. 1998;28(suppl 2):3-10 Ann Allergy Ashma Immunol. 1999;82:233-252 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 过过敏反应应在靶器官的临临床表现现 过过敏性疾病 /反应应 靶器官 /位点临临床表现现 鼻炎鼻喷喷嚏, 鼻溢, 鼻痒, 鼻堵 哮喘肺咳嗽, 喘, 呼吸短促 皮炎皮肤痒, 疹 结结膜炎眼 痒, 红红, 流泪 过过敏症全身/系统统低血压压, 休克, 死亡 食物肠肠胃气胀胀, 恶恶心,呕吐, 痛性痉挛痉挛 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 肥大细细胞和嗜碱性粒细细胞脱颗颗粒释释放出的活性介质质, 包括预预先储储存的介质质和受刺激后新产产生的介质质两大 类类 颗颗粒内预预先储储存的介质质 1.组组胺(histamine) 2.嗜酸性粒细细胞趋趋化因子(ECF-A),对对嗜酸性粒细细 胞具有趋趋化作用的四肽肽 3.激肽肽(Kinin)激肽肽原酶从颗颗粒中释释出后作用于九 肽肽即缓缓激肽肽 参与过过敏反应应的主要活性介质质 《《皮肤性病免疫学》皮肤性病免疫学》 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 细细胞内新合成的介质质 1.白三烯烯(LT)是活化的肥大细细胞、嗜碱性粒细细胞 膜内磷脂代谢过谢过 程中产产生的花生四稀酸经经脂氧合 酶形成的衍生物,包括LTC4、LTD4和LTE4 2.前列腺素(PG)是花生四稀酸经环经环 氧合酶代谢产谢产 生的介质质,包括PGD、PGE1、PGE2和PGF2α 3.血小板活化因子(PAF)也是花生四稀酸的衍生 物,可能由巨噬细细胞等其他细细胞释释放 参与过过敏反应应的主要活性介质质 《《皮肤性病免疫学》皮肤性病免疫学》 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 与过过敏反应应致病作用有关的活性介质质 《《皮肤性病免疫学》皮肤性病免疫学》 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 过过敏性疾病的病理过过程 过过敏性疾病代表了针对针对 抗原的过过度的免疫 反应应,病理机制包括: – 早期相(速发过发过 敏性反应应)接触抗原后数分 钟钟开始,30-90分钟钟逐渐渐消退, – 晚期相(迟发迟发 性过过敏反应应)通常在早期相后 4-8小时发时发 生,持续续数天 – 慢性炎性反应过应过 程 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 免疫反应应--早期相 • 抗原和肥大细细胞的抗体结结合引起早期反应应 的发发生,肥大细细胞脱颗颗粒,释释放炎性前分 子,如组组胺、白三烯烯、前列腺素和血小板 激活因子PAF。 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 早期相的临临床表现现 • 呼吸道表现现主要为为:喘鸣鸣、鼻痒、喷喷 嚏等 • 皮肤主要表现为荨现为荨 麻疹。 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 免疫反应应—晚期相 •嗜酸性粒细细胞和淋巴细细胞是最基本的 效应细应细 胞 •嗜碱性粒细细胞和中性粒细细胞也有参与 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 晚期相的临临床表现现 • 呼吸道:鼻部充血、鼻粘膜分泌增 加和气道高反应应性, • 皮肤:红红斑、瘙痒和水肿肿。 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 嗜酸性粒细细胞产产生独特的毒性物质质,在 颗颗粒中储储存,细细胞激活后合成以上提到的 主要的嗜酸性粒细细胞阳离子蛋白、嗜酸性 粒细细胞神经经毒素、基本蛋白和嗜酸性粒细细 胞过过氧化物酶等物质质,引起炎性前效应应和 细细胞毒性效应应。 慢性炎性过过程 -嗜酸细细胞的组织组织 破坏作用 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 变应性皮炎变应性皮炎 荨麻疹荨麻疹 结膜炎结膜炎 哮喘哮喘 过敏性鼻炎过敏性鼻炎 食物过敏食物过敏 ALLERGYALLERGY - - A A SYSTEMIC SYSTEMIC DISEASEDISEASE 过过过过敏性疾病是系敏性疾病是系统统统统性疾病性疾病 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 过过敏性疾病的新认识认识 • 过过敏性疾病是一种全身性的炎性反应应性过过 程,是局部变态变态 反应应相互作用影响因素的 主要原因。 • 对过对过 敏性疾病的治疗疗,不仅仅要治疗疗局部反 应应,还还需要考虑对虑对 全身性的炎性反应过应过 程 的治疗疗。 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 内容摘要 • 过过敏性疾病的概述 • 白三烯烯受体拮抗剂剂的作用和地位 --白三烯烯受体拮抗剂剂在儿童哮喘 --运动诱发动诱发 哮喘 --婴婴幼儿喘息 --慢性咳嗽 --白三烯烯受体拮抗剂剂在儿童过过敏性鼻炎 --白三烯烯受体拮抗剂剂在儿童皮炎 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 白三烯烯受体拮抗剂剂 在儿童哮喘中的地位 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 中心气道中心气道 周围气道周围气道 Evans J, et al. Evans J, et al. Clin Exp Allergy Rev 2001;1:142-4Clin Exp Allergy Rev 2001;1:142-4 呼吸性细支气管呼吸性细支气管 上皮上皮 平滑肌平滑肌 肺泡肺泡 肺泡管肺泡管 白三烯受体在气道的表达 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. ≥5岁岁儿童哮喘的长长期治疗疗方案( GINA2009) This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 5岁岁儿童哮喘的长长期治疗疗方案 (GINA2009) This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 或 儿童持续续性哮喘的初始控制治疗疗采用ICS 或 LTRA PRACTALL EAACI / AAAAI 共识报告 摘自 Bacharier LB, et al. Allergy. 2008;63(1):5–34. •持续续性哮喘的一线线治疗疗 •当哮喘控制不理想时应时应 作为为初始维维 持治疗疗 •遗传过遗传过 敏性和肺功能较较差预预示治疗疗 反应较应较 好 •如果低剂剂量ICS控制不理想,明确原 因。 如果有指征,应应考虑虑增加ICS剂剂 量或增加LTRA或LABA •年龄较龄较 大的儿童,一旦治疗疗停止, 疗疗效便开始消失 •新的数据未发现发现 学龄龄前儿童停药药后 具有改变变疾病状态态的作用 •持续续性哮喘的一线线治疗疗之一 •有证证据支持 LTRA用于儿童轻轻度哮喘 的初始控制治疗疗 •年幼(10岁岁以下)和尿白三烯烯水平高 预预示治疗疗反应较应较 好 •可用于治疗疗无法使用或不愿使用ICS的 患者 •也可作为为ICS的添加治疗疗:不同和互补补 的作用机制 •建议议病毒诱发诱发 喘鸣鸣的低龄龄儿童使用 •最小可用于6个月患儿 •如果患者合并鼻炎,LTRA尤其有益 ICS (200 µg BDP 等效剂剂量) LTRA (剂剂量随着年龄龄而变变化) PRACTALL 建议议: This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 儿童(2-5岁岁)在ICS应应用方面问题问题 l不正确的吸入方法 l笨重昂贵贵的设备设备 lICS不是特别别有效 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. Adapted from www.asthmainamerica.com/children_slide_kit.html. N=801 † *哮喘患儿(16岁)照顾者和哮喘患儿( ≥ 16岁)自己所述现有的和完全控制的哮喘症状. † “实际 控制” 的定义源自美国哮喘调查结 果。此调查发现 根据1997年国立卫生研究院(NIH)指南(一周症状≤2), 34%的成人患者所述症状可归类为轻 度间歇性哮喘 ;这和2007年 NHLBI 对症状控制良好(每周≤2天)的成人哮喘 分类中“实际 控制”定义是相互联系的。此定义并未参考NHLBI 定义控制良好哮喘的其它标准。 照顾者高估了儿童哮喘的控制水平 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. *和其它年龄组龄组 相比成人组组治疗疗效果更显显著 (p=0.004). -4 -3 -2 -1 0 ￿￿ 10 岁11-17 岁 ￿￿ 18 岁* 布地奈德疗疗法 参考疗疗法 BD应应用后 FEV1 变变化(% 预计值预计值 ) Reprinted with permission from Pauwels RA, et al. Lancet. 2003;361:1071-6. STARTSTART研究研究 ( (应应应应用用ICSICS对轻对轻对轻对轻 度哮喘行早期治度哮喘行早期治疗疗疗疗): ): 应应应应用用BDBD后后 FEV FEV 1 1 ( (预计值预计值预计值预计值 比例比例)3)3年年变变变变化的年化的年龄龄龄龄效效 应应应应 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. LABA对对儿童哮喘急性加重的疗疗效 0.1 0.20.512510 RR (95% Cl ) Bensch8 Von Berg11 Lenney9 Zarkovic5 Langton Hewer12 Tal13 Akpinarli7 Verbene10 21.7 35.0 26.0 11.6 1.2 1.3 0.0 3.2 权重 (%) 倾向LABA倾向对照药物 20 40 30 比例% 0-34-67-910-12 加重比例 LABASABA Bisgaard H. Pediatr Pulmonol. 2003;36:391–398. This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 结论结论 : 2010年2月 美国 FDA 关于LABA安全性会议议 • LABA不能单单用,必须须和ICS一起使用 • LABA应该应该 在控制药药物治疗疗无效以后加用 • LABA应该应该 在哮喘控制后尽快停用,继续继续 使用控制药药物 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 白三烯烯受体拮抗剂剂 在儿童哮喘中的作用 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 白三烯烯受体拮抗剂剂的作用 – 抑制气道嗜酸粒细胞炎症 – 抑制炎症介质和细胞因子释放 – 降低呼出气一氧化氮 – 抑制气道LTC4释放 – 改善肺功能,降低气道的高反应性 – 抑制气道重塑 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. *p0.05 compared with beclomethasone Adapted from LaViolette M et al Am J Respir Crit Care Med 1999;160:1862-1868. 0.12 0.10 0.08 0.06 0.04 0.02 0 Eosinophil counts (change from baseline ￿￿ 103/µl) PlaceboBeclomethasone Montelukast + beclomethasone Montelukast * 1* Treatment group LTRA Montelukast Further Reduced Asthmatic Inflammation Complementary therapy that targets dual pathways of inflammation provided better control of inflammation * 1* This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 外周气道炎症与夜间哮喘的关系(1 ) nocturnal nocturnal asthmaasthma Non-nocturnal Non-nocturnal asthmaasthma This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 外周气道炎症与夜间哮喘的关系(2 ) This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using
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