一、哮喘的癥狀有哪些
1、病人在(zai)發作以(yi)前(qian)會出現鼻塞、眼睛(jing)痕癢(yang)、愛(ai)打噴嚏、甚至會有種莫名的恐懼(ju)感。
2、部分(fen)病(bing)人(ren)發作(zuo)的(de)(de)時(shi)候會出現(xian)胸悶(men),呼吸困(kun)難、咳(ke)嗽,偶爾會伴(ban)有哮鳴音,十分(fen)痛苦(ku)難受,如果患者(zhe)在這(zhe)個時(shi)候沒(mei)有及時(shi)的(de)(de)得到緩解,有可能會出現(xian)休克的(de)(de)現(xian)象(xiang),這(zhe)種情況大多數發生(sheng)在夜(ye)間近(jin)凌晨的(de)(de)時(shi)段。
3、部分患者只會出現(xian)干咳(ke),或者帶痰,但痰液是極度濃(nong)稠,所以患者會拼命的(de)咳(ke)嗽,但是都無(wu)法(fa)把痰液咳(ke)出,非(fei)常難(nan)受。
4、如果患(huan)者(zhe)是兒童病人,一般隨著(zhu)年(nian)齡(ling)的增(zeng)長,哮(xiao)喘會隨著(zhu)年(nian)齡(ling)的增(zeng)長越(yue)發嚴重,復發次數會增(zeng)加,反復次數較高。
二、引起哮喘的原因是什么
1、遺傳因素
哮喘是(shi)一種具(ju)有復雜性(xing)狀的,具(ju)多(duo)基因遺傳(chuan)傾向的疾病。其特(te)征為:①外顯(xian)不(bu)全,②遺傳(chuan)異質(zhi)化,③多(duo)基因遺傳(chuan),④協(xie)同作用(yong)。
2、變應原
哮喘最重要(yao)的激(ji)發因素可能是吸入變應原。
(1)室內(nei)變應(ying)原
屋(wu)螨(man)(man)是(shi)(shi)最(zui)(zui)常(chang)見(jian)的(de)(de)(de)(de)(de),危害(hai)最(zui)(zui)大的(de)(de)(de)(de)(de)室(shi)內(nei)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan),是(shi)(shi)哮(xiao)喘(chuan)(chuan)(chuan)在(zai)(zai)(zai)(zai)(zai)世界范圍(wei)內(nei)的(de)(de)(de)(de)(de)重(zhong)要(yao)(yao)(yao)發病因素(su)。常(chang)見(jian)的(de)(de)(de)(de)(de)有4種:屋(wu)塵(chen)螨(man)(man),粉(fen)(fen)塵(chen)螨(man)(man),宇塵(chen)螨(man)(man)和(he)(he)多毛螨(man)(man)。90%以(yi)(yi)上螨(man)(man)類(lei)存在(zai)(zai)(zai)(zai)(zai)屋(wu)塵(chen)中(zhong)(zhong),屋(wu)塵(chen)螨(man)(man)是(shi)(shi)持續潮濕氣(qi)(qi)候(hou)最(zui)(zui)主(zhu)(zhu)(zhu)要(yao)(yao)(yao)的(de)(de)(de)(de)(de)螨(man)(man)蟲(chong)。主(zhu)(zhu)(zhu)要(yao)(yao)(yao)抗原(yuan)(yuan)為(wei)(wei)DerpI和(he)(he)DerpⅡ,主(zhu)(zhu)(zhu)要(yao)(yao)(yao)成(cheng)分(fen)(fen)(fen)為(wei)(wei)半胱(guang)氨(an)酸(suan)蛋(dan)(dan)白(bai)酶或酪氨(an)酸(suan)蛋(dan)(dan)白(bai)酶。家中(zhong)(zhong)飼養寵(chong)物(wu)如貓、狗(gou)、鳥釋放變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan)在(zai)(zai)(zai)(zai)(zai)它(ta)們的(de)(de)(de)(de)(de)皮(pi)(pi)毛、唾(tuo)液(ye)(ye)、尿液(ye)(ye)與(yu)糞便等分(fen)(fen)(fen)泌物(wu)里。貓是(shi)(shi)這些動物(wu)中(zhong)(zhong)最(zui)(zui)重(zhong)要(yao)(yao)(yao)的(de)(de)(de)(de)(de)致(zhi)敏者,其主(zhu)(zhu)(zhu)要(yao)(yao)(yao)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan)成(cheng)分(fen)(fen)(fen)feldl,存在(zai)(zai)(zai)(zai)(zai)貓的(de)(de)(de)(de)(de)皮(pi)(pi)毛及(ji)皮(pi)(pi)脂分(fen)(fen)(fen)泌物(wu)中(zhong)(zhong),是(shi)(shi)引起(qi)(qi)哮(xiao)喘(chuan)(chuan)(chuan)急性發作的(de)(de)(de)(de)(de)主(zhu)(zhu)(zhu)要(yao)(yao)(yao)危險因子。蟑螂(lang)為(wei)(wei)亞(ya)洲國家常(chang)見(jian)的(de)(de)(de)(de)(de)室(shi)內(nei)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan);與(yu)哮(xiao)喘(chuan)(chuan)(chuan)有關的(de)(de)(de)(de)(de)常(chang)見(jian)為(wei)(wei)蟑螂(lang)美洲大蠊(lian)(lian)、德國小(xiao)蠊(lian)(lian)、東(dong)方小(xiao)蠊(lian)(lian)和(he)(he)黑胸(xiong)大蠊(lian)(lian),其中(zhong)(zhong)以(yi)(yi)黑胸(xiong)大蠊(lian)(lian)在(zai)(zai)(zai)(zai)(zai)我國最(zui)(zui)為(wei)(wei)常(chang)見(jian)。真菌(jun)亦是(shi)(shi)存在(zai)(zai)(zai)(zai)(zai)于室(shi)內(nei)空(kong)氣(qi)(qi)中(zhong)(zhong)的(de)(de)(de)(de)(de)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan)之一,特(te)別(bie)是(shi)(shi)在(zai)(zai)(zai)(zai)(zai)陰(yin)暗、潮濕以(yi)(yi)及(ji)通風不良(liang)的(de)(de)(de)(de)(de)地方,常(chang)見(jian)為(wei)(wei)青霉、曲(qu)霉、交鏈(lian)孢霉、分(fen)(fen)(fen)支孢子菌(jun)和(he)(he)念(nian)珠(zhu)菌(jun)等。其中(zhong)(zhong)鏈(lian)格孢霉已被確認(ren)為(wei)(wei)致(zhi)哮(xiao)喘(chuan)(chuan)(chuan)的(de)(de)(de)(de)(de)危險因子。常(chang)見(jian)的(de)(de)(de)(de)(de)室(shi)外(wai)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan):花(hua)粉(fen)(fen)與(yu)草(cao)粉(fen)(fen)是(shi)(shi)最(zui)(zui)常(chang)見(jian)的(de)(de)(de)(de)(de)引起(qi)(qi)哮(xiao)喘(chuan)(chuan)(chuan)發作的(de)(de)(de)(de)(de)室(shi)外(wai)變(bian)(bian)(bian)應(ying)(ying)原(yuan)(yuan)。木本植物(wu)(樹花(hua)粉(fen)(fen))常(chang)引起(qi)(qi)春季哮(xiao)喘(chuan)(chuan)(chuan),而禾(he)本植物(wu)的(de)(de)(de)(de)(de)草(cao)類(lei)和(he)(he)莠(you)草(cao)類(lei)花(hua)粉(fen)(fen)常(chang)引起(qi)(qi)秋季哮(xiao)喘(chuan)(chuan)(chuan)。我國東(dong)部地區主(zhu)(zhu)(zhu)要(yao)(yao)(yao)為(wei)(wei)豚草(cao)花(hua)粉(fen)(fen);北部主(zhu)(zhu)(zhu)要(yao)(yao)(yao)為(wei)(wei)蒿草(cao)類(lei)。
(2)職業性變應原
可引起職業性哮喘常見的變(bian)應原有谷物粉、面粉、木材、飼料(liao)、茶(cha)、咖啡(fei)豆、家蠶、鴿子、蘑菇、抗生素(青霉(mei)素、頭孢霉(mei)素)異氰酸鹽、鄰苯二甲酸、松(song)香(xiang)、活性染(ran)料(liao)、過(guo)硫酸鹽、乙(yi)二胺等。
(3)藥物及食物添加劑
阿司(si)匹林(lin)和(he)一(yi)些非皮質激素類抗炎藥是(shi)(shi)藥物(wu)(wu)所致哮(xiao)喘(chuan)(chuan)的(de)主要變(bian)應原(yuan)。水楊酸酯、防腐劑(ji)及染色劑(ji)等食物(wu)(wu)添(tian)加劑(ji)也可引起哮(xiao)喘(chuan)(chuan)急(ji)性(xing)發作(zuo)。蜂(feng)(feng)王漿(jiang)口服液是(shi)(shi)我國(guo)及東(dong)南亞地區(qu)國(guo)家和(he)地區(qu)廣(guang)泛用來(lai)作(zuo)為健康保健品的(de)食物(wu)(wu)。目前已證實蜂(feng)(feng)王漿(jiang)可引起一(yi)些病(bing)人哮(xiao)喘(chuan)(chuan)急(ji)性(xing)發作(zuo),是(shi)(shi)由IgE介(jie)導的(de)變(bian)態反應。
3、促發因素
(1)大氣污染
空氣(qi)污染(SO2、NO)可致支氣(qi)管收縮、一過性(xing)氣(qi)道(dao)反應(ying)性(xing)增高并能增強對(dui)變應(ying)原(yuan)的反應(ying)。
(2)吸煙
香煙(yan)(yan)煙(yan)(yan)霧(包括被動吸煙(yan)(yan))是戶內促發因素的(de)主要(yao)來源,是一種重要(yao)的(de)哮喘(chuan)促發因子,特別是對于那些父母(mu)抽煙(yan)(yan)的(de)哮喘(chuan)兒童,常因吸煙(yan)(yan)引起哮喘(chuan)發作。
(3)呼吸道(dao)病毒感染(ran)
呼(hu)吸(xi)道(dao)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)感(gan)(gan)染(ran)與(yu)(yu)哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)發作有(you)密(mi)切關系(xi)。嬰兒(er)(er)(er)(er)支氣(qi)管病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)感(gan)(gan)染(ran)作為(wei)(wei)哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)發病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)的(de)啟動病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)因尤其受到關注。呼(hu)吸(xi)道(dao)感(gan)(gan)染(ran)常見病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)有(you)呼(hu)吸(xi)道(dao)合(he)胞病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)(RSV)、腺病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、鼻病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、流(liu)感(gan)(gan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、副流(liu)感(gan)(gan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、冠狀(zhuang)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du),以(yi)及某些腸道(dao)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)。與(yu)(yu)成人(ren)哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)有(you)關的(de)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)以(yi)鼻病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)和(he)流(liu)感(gan)(gan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)為(wei)(wei)主;呼(hu)吸(xi)道(dao)合(he)胞病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、副流(liu)感(gan)(gan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)、腺病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)和(he)鼻病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)則與(yu)(yu)兒(er)(er)(er)(er)童哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)發作關系(xi)密(mi)切。合(he)胞病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)(du)(du)是出生(sheng)(sheng)后(hou)(hou)第一年(nian)的(de)主要(yao)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)(bing)原,在2歲以(yi)下的(de)感(gan)(gan)染(ran)性哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)中占(zhan)44%,在大兒(er)(er)(er)(er)童哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)中也(ye)有(you)10%以(yi)上與(yu)(yu)其感(gan)(gan)染(ran)有(you)關。有(you)人(ren)報道(dao):RSV感(gan)(gan)染(ran)后(hou)(hou)的(de)近100%的(de)哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)或(huo)毛細支氣(qi)管炎(yan)患者的(de)上皮(pi)細胞有(you)IgE附著。因急(ji)性RSV感(gan)(gan)染(ran)住(zhu)院(yuan)的(de)兒(er)(er)(er)(er)童在10年(nian)后(hou)(hou),有(you)42%發生(sheng)(sheng)哮(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)。
(4)圍生期胎(tai)兒的環境(jing)
妊娠9周的(de)胎(tai)兒(er)胸腺已可產生(sheng)T淋巴細(xi)胞(bao)(bao),第(di)19~20周,在胎(tai)兒(er)各器官中(zhong)已產生(sheng)B淋巴細(xi)胞(bao)(bao),由于在整個妊娠期胎(tai)盤主要產生(sheng)輔助性Ⅱ型(xing)T細(xi)胞(bao)(bao)(Th2)細(xi)胞(bao)(bao)因子,因而在肺的(de)微環(huan)境中(zhong),Th2的(de)反(fan)(fan)應(ying)是占優(you)勢的(de),若母親已有特(te)異(yi)性體質,又在妊娠期接觸大(da)量的(de)變(bian)(bian)應(ying)原(如牛奶中(zhong)的(de)乳球蛋(dan)白,雞(ji)蛋(dan)中(zhong)的(de)卵蛋(dan)白或螨蟲的(de)DerpI等)或受到呼吸道病毒特(te)別是合胞(bao)(bao)病毒的(de)反(fan)(fan)復(fu)感染,即可能(neng)加(jia)重其Th2調(diao)控的(de)變(bian)(bian)態反(fan)(fan)應(ying),以至增加(jia)出(chu)生(sheng)后變(bian)(bian)態反(fan)(fan)應(ying)和哮喘(chuan)發病的(de)可能(neng)性。
此外,在妊娠晚期體內攝入(ru)多價(jia)不飽和脂肪酸(suan)的(de)數量,將影(ying)響前列腺素E的(de)生(sheng)成,對Th2細胞調(diao)控的(de)變態反應可能有關。母親在妊娠期間吸(xi)煙肯定(ding)會影(ying)響胎兒的(de)肺功能及日后發生(sheng)喘鳴的(de)易感性。
(5)其他
劇(ju)烈運動(dong)、氣(qi)候轉變及多(duo)種非特(te)異性刺激如:吸(xi)入冷空氣(qi)、蒸餾(liu)水霧滴(di)等。此外(wai),精神因素亦可誘發(fa)哮喘。
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