mob hawb pob yog ib yam kab mob ntev thiab feem ntau tshwm sim. Qhov no yog hom kev ua xua hnyav tshaj plaws. Nce rhiab heev ntawm bronchi mus rau ntau yam kev cuam tshuam ib puag ncig ua rau mob o.
Tus kab mob tuaj yeem yog los ntawm keeb kwm lossis kis tau. Peb yuav xav txog bronchial hawb pob - pathogenesis, chaw kho mob, kev kho mob ntawm tus kab mob no. Tag nrho cov no tseem ceeb heev kom paub thiab kawm kom zoo yog tias muaj ib tus neeg hauv tsev neeg raug kev txom nyem los ntawm kab mob no.
Basic concepts
Qhov no yog ib qho mob hnyav uas tiv thaiv kev ua pa tsis zoo vim txoj kev nqaim ua rau lub ntsws. Kev tawm tsam tuaj yeem ploj mus ntawm lawv tus kheej, tab sis hauv kev ua liaj ua teb hnyav dua, tsuas yog cov tshuaj pab. Dab tsi yog qhov pathogenesis ntawm bronchial hawb pob? Lub tswv yim ntawm tus kab mob yog xws li tias vim ntau tshaj ntawm cov mucus tsim, spasms thiab inflammatory edema, cov phab ntsa ntawm lub bronchus thicken, thiab qhov sib txawv ntawm lawv nqaim. Raws li qhov tshwm sim, tsis muaj cua txaus, uas ua rau muaj kev cuam tshuam ntawm kev nqhis dej, hnoos, hawb pob thiab lwm yam mob hawb pob.
Los ntawmTus kab mob no raug kev txom nyem, raws li kev txheeb cais, 5% ntawm cov neeg nyob sab Europe, feem ntau cov hluas. Raws li txoj cai, cov no yog cov menyuam yaus hnub nyoog qis dua 10 xyoo. Txawm hais tias cov tshuaj niaj hnub tshawb nrhiav cov kab mob no cuam tshuam nrog bronchial hyperactivity, qhov ua rau nws txoj kev loj hlob, kev kho mob thiab kev tiv thaiv tseem tsis tau nkag siab tag nrho. Cov etiology thiab pathogenesis ntawm bronchial hawb pob feem ntau baffle zaum. Tab sis tus kab mob no tshwm sim li cas?
Pathogenesis ntawm bronchial hawb pob
Pathogenesis - lub txheej txheem ntawm kev txhim kho kab mob - muaj 2 theem:
- Immunological. Thaum ib qho excitatory allergen nkag mus rau hauv lub cev tiv thaiv kab mob, o ntawm mucous membrane tshwm sim.
- YPathophysiological. Cov tshuaj tiv thaiv ntuj tsim ntawm bronchi rau cov txheej txheem inflammatory tshwm sim hauv lub cev.
Lub tshuab ntawm cov tsos mob ntawm bronchospasm yog ua raws li hauv qab no: rau lub sijhawm ntev, cov mucosa ntawm tsob ntoo bronchial cuam tshuam los ntawm kev khaus. Lub mucosa swells, thiab hypersecretion tshwm sim, uas ua rau qaug dab peg. Yuav ua li cas rau lub cev thaum mob hawb pob?
Pathogenesis yog nrog los ntawm cov kab mob hauv qab no:
- Hyperestrogenemia, ua rau muaj kev nce hauv kev ua haujlwm ntawm α-adrenergic receptors thiab txo qis hauv kev ua haujlwm ntawm β-adrenergic receptors. Nrog rau sab nraud raug rau cov allergen, bronchospasm tsim ib txhij nrog cov txheej txheem no.
- Glucocorticosteroid deficiency nce qib ntawm histamine thiab lub suab ntawm lub bronchi, uas ua rau rhiab rau stimuli.
- Hyperthyroidism. Tus kab mob no zuj zus thiab loj hlob sai hauv cov neeg uas muajnce cov thyroid hormones.
Lub pathogenesis ntawm bronchial hawb pob yog txiav txim siab los ntawm kev soj ntsuam thiab kuaj kab mob. Cov kev hloov pauv tshwm sim hauv lub cev tuaj yeem ua rau sab hauv thiab sab nraud. Lwm yam tseem ceeb uas cuam tshuam rau txoj kev loj hlob ntawm pathology:
- psycho-emotional state;
- kev nyuaj siab;
- kev ua lub cev;
- raug rau kev ua xua;
- kev cuam tshuam ntawm cov tshuaj irritants;
- kev nyab xeeb tsis zoo.
Internal factors:
- cuam tshuam hauv qhov system endocrine;
- kev tiv thaiv tsis zoo;
- bronchial hyperactivity.
Lub tsev plua plav yog ib qho ntawm cov provocateurs tseem ceeb uas ua rau mob hawb pob. Nws muaj ntau yam kab mob uas muaj zog ua xua.
Kev qaug dab peg
Txawm hais tias muaj cov kab mob ntawm cov kab mob bronchial hawb pob thiab cov kab mob, nws yuav tsum tau ua tam sim ntawd. Qhov kev tawm tsam yuav luv luv lossis ntev li ob peb teev. Tom qab ntawd, tus neeg mob tau zoo dua, thiab zoo li nws kho tau tag nrho.
Nws tag nrho yog nyob ntawm theem ntawm tus kab mob. Tus neeg yuav muaj kev cuam tshuam me me ntawm txoj hlab pa. Cov theem hnyav tuaj yeem tshwm sim nws tus kheej li ob peb hnub thiab rub mus rau lub lis piam. Daim ntawv no hu ua xwm txheej asthmaticus. Cov kab mob no txaus ntshai heev thiab tuaj yeem ua rau tuag taus.
Rau txhua hom kab mob muajpathogenic mechanisms. Ntawm cov neeg sawv daws, ib tus tuaj yeem tawm ib qho kev hloov pauv hauv qhov ua kom muaj zog thiab rhiab ntawm lub bronchi, soj ntsuam hauv cov lus teb rau lub cev lossis tshuaj tshuaj.
Thaum ua rau muaj kev xeeb tub
Ib tug neeg uas muaj caj ces mob hawb pob yuav tsis hnov nws, lossis nws yuav ua rau nws tus kheej hnov thaum muaj hnub nyoog:
- 50% - menyuam yaus hnub nyoog qis dua 10 xyoo;
- 30% - txog 40 xyoo;
- 20% - tom qab 50 xyoo.
Txoj kev xeeb leej xeeb ntxwv yog lub hauv paus ua rau kev loj hlob ntawm tus kab mob. Yog tias cov niam txiv raug mob hawb pob, qhov tshwm sim uas tus kab mob yuav kis mus rau tus menyuam yog 30%. Txawm li cas los xij, pathology nws tus kheej tsis tuaj yeem tshwm sim nws tus kheej, nws yuav tsum tau provoked los ntawm ib yam dab tsi.
Ntawd yog, nrog kev sib xyaw ntawm sab hauv, sab nraud thiab qhov tseeb ntawm cov kab mob tshwm sim, qhov kev pheej hmoo ntawm kev ua rau cov txheej txheem ntawm kev kis kab mob nce ntau zaus.
mob hawb pob
Cov pa ntawm cov neeg mob hawb pob bronchial yog qhov khaus heev thiab rhiab heev. Kev qaug dab peg kuj tseem hu ua triggers:
- huab cua puag;
- ib puag ncig xwm txheej;
- paj ntoos, pwm, nceb;
- kev xav;
- kev tawm dag zog ntau dhau;
- haus luam yeeb, haus luam yeeb;
- tshuaj;
- food;
- tsev mites;
- tsiaj.
Txhua tus neeg muaj qhov sib txawv ntawm cov kab mob bronchial hawb pob, kev tawm tsam tuaj yeem tshwm sim los ntawm ib qho lossisntau yam stimuli.
External impact
Feem ntau, mob hawb pob yog ua ke ntawm ntau yam cuam tshuam rau lub cev tib lub sijhawm. Lawv raug muab faib ua ob peb pawg:
- kab mob;
- allergens;
- mechanical and chemical stimuli;
- meteorological yam;
- tshuaj.
Allergens muaj xws li cov plua plav hauv tsev, paj paj ntoo, zaub mov, tshuaj, kab, tsiaj. Cov kab mob sib kis: kab mob, kab mob, fungus. Mechanical thiab tshuaj irritants: paj rwb los yog silicate plua plav, pa luam yeeb, alkali thiab acid fumes. Kev cuam tshuam huab cua suav nrog kev hloov pauv huab cua thiab huab cua siab.
Kev mob hawb pob tuaj yeem ua rau muaj kev cuam tshuam los ntawm b-blockers siv los tiv thaiv ntshav siab, tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob. Raws li tus kab mob loj tuaj, qhov tshwm sim tuaj yeem hloov pauv.
Thaum qhov teeb meem yog los ntawm sab hauv
Bronchial hawb pob tuaj yeem tshwm sim los ntawm kev cuam tshuam tsis tu ncua ntawm lub cev tiv thaiv kab mob, endocrine system, metabolism, nce kev ua haujlwm ntawm receptors hauv bronchial mucosa, thiab ua haujlwm tsis zoo hauv lub paj hlwb. Tag nrho cov cim no yog tshwm sim los ntawm kev ua neej tsis raug, kab mob sib kis, nyob hauv ib puag ncig tsis zoo.
Etiology of hawb pob
Lub etiology thiab pathogenesis ntawm bronchial hawb pob yog tias tus kab mob yog heterogeneous thiab yog txuam nrog kev kho mob thiab kis kab mob,ua rau mob mob. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qhov kev sib txawv no feem ntau yog cov khoom tsim thiab cuam tshuam rau cov subcategory ntawm kev faib tawm.
Hais txog qib molecular, cov kab mob ntawm bronchial hawb pob yog ob hom: ua xua thiab peculiar. Thawj qhov feem ntau cuam tshuam nrog tsev neeg keeb kwm ntawm cov mob xws li:
- eczema;
- rhinitis;
- tawm tsam ntawm erythematous papules;
- urticaria.
Qhov pib tshwm sim ntawm pathology tuaj yeem nrog cov tsos mob zoo li tus mob khaub thuas, tab sis tom qab ob peb hnub ua tsis taus pa, hawb pob, hawb pob thiab lwm yam tsos mob ntawm bronchial hawb pob tshwm.
Symptomatics
Nyob ntawm qhov hnyav thiab daim ntawv, bronchial hawb pob muaj cov tsos mob sib txawv. Etiology, pathogenesis, kev faib tawm yog tsim raws li cov cim qhia xws li hnoos me ntsis, hawb pob, ua tsis taus pa, mob hauv siab lossis mob hawb pob. Nrog rau cov tsos mob zaum kawg, kev kuaj mob los ntawm kws kho mob yog qhov tsim nyog thiab tseem ceeb heev.
Thaum qhov kev ntsuam xyuas tau ua tiav thiab kuaj pom tau, feem ntau yog tshuaj inhaler. Tab sis nyob rau hauv rooj plaub uas nws siv ntau zaus dua li nws tau sau tseg, koj yuav tsum tau nrhiav kev pab los ntawm koj tus kws kho mob sai.
Yog li ntawm 1-2 hnub cov tsos mob tsis ploj mus, thiab lub tshuab nqus pa tsis pab, yuav tsum tau pw hauv tsev kho mob. Thaum lub sijhawm muaj mob hawb pob thiab hais lus nyuaj, lub tsheb thauj neeg mob hu ua.
Cov tsos mob sib xws
Thaum lub sijhawm exacerbation, tus neeg mob muaj qhov tshwm sim ntau ntxiv raumuaj zog tsw thiab kub hloov pauv. Qhov no qhia txog cov txheej txheem inflammatory thiab ua kom cov tshuaj kho mob. Ib qho ntawm cov cim tseem ceeb tshaj plaws yog kev txhim kho ntawm tus mob los ntawm kev noj tshuaj tiv thaiv kab mob (Zirtek, Cetrin, thiab lwm yam) thiab, raws li, tom qab nqus tau pa. Cov tsos mob ntxiv:
- kiv taub hau;
- dav dav thiab tsis muaj zog;
- tachycardia (lub plawv dhia ceev);
- daim tawv nqaij xiav;
- kos npe ntawm emphysema.
Nws tsis tuaj yeem tshem tawm cov xwm txheej asthmaticus nrog kev kho mob ib txwm muaj, qhov kev tawm tsam no nrog rau kev ua tsis taus pa ntev thiab tsis nco qab. Tus mob no tuaj yeem ua rau tuag taus.
Cov tshuaj tiv thaiv kab mob hawb pob nyob rau hauv kev sib raug zoo rau kev ceev ntawm bronchial teb rau ib qho allergen tuaj yeem ntxov lossis lig. Hauv thawj kis, kev tawm tsam pib tom qab 1-2 feeb thiab xaus tom qab 20 feeb. Tag nrho lub sijhawm ntawm tus mob hawb pob tuaj yeem kav ntev txog 2 teev. Qhov kawg theem ua rau bronchial hyperactivity tom qab 4-6 teev, culminating tom qab 8 teev. Lub sijhawm ntawm kev tawm tsam yog 12 teev.
Kev nyuaj siab:
- mob ntsws emphysematous;
- mob ua pa tsis ua haujlwm;
- thaum huab cua nkag mus rau hauv pleural kab noj hniav, pneumothorax tsim.
Raws li etiology, ntau hom mob hawb pob yog qhov txawv:
- exogenous (provoked los ntawm ib qho allergen);
- endogenous (provoked los ntawm kev ntxhov siab thiab kab mob);
- mixed genesis.
hom mob hawb pob ntau tshaj plaws yog atopic, uas tshwm sim los ntawm kev tshuaj ntsuam genetic predisposition rau kev tsis haum tshuaj.
Dab tsi tseem ceeb kom paub
Thawj qhov yuav tsum ua yog mus ntsib kws kho mob, kuaj xyuas tag nrho, tsim kom muaj kev kuaj mob kom raug thiab tau txais cov lus pom zoo rau kev kho mob. Tsuas yog tus kws kho mob paub tias yam kab mob xws li mob ntsws asthma muaj, etiology, pathogenesis, chaw kho mob, kev kho mob. Nws yog ib qho tseem ceeb uas tus neeg mob nws tus kheej thiab nws cov txheeb ze yeej ib txwm npaj rau kev tawm tsam tshiab thiab paub pab.
Txhawm rau muab kev pabcuam zoo, koj yuav tsum muaj cov ntaub ntawv qhia ntxaws txog txhua yam tsos mob, theem thiab hom kab mob. Nws yog ib qho tseem ceeb kom paub tias qhov pathogenesis ntawm bronchial hawb pob yog dab tsi. Luv luv, cov lus qhia hauv qab no tuaj yeem muab tau: ib txoj kev kho kom meej meej yuav tsum tau kos nrog cov lus qhia uas piav qhia yuav ua li cas hauv kev tawm tsam hnyav. Tsis yog ib qho kev pom zoo, cov lus qhia lossis tus kws kho mob cov tshuaj yuav tsis quav ntsej, nws tuaj yeem ua rau tus neeg mob lub neej. Cov tshuaj tau noj nruj me ntsis raws li qhia, tsuas yog nyob rau hauv cov koob tshuaj qhia thiab nyob rau lub sijhawm.
Ntawm tes, txawm tus neeg mob nyob qhov twg los, nws thiab cov neeg nws hlub yuav tsum muaj cov tshuaj tsim nyog, tshuaj pab thawj zaug thiab tshuaj nqus pa. Nws tseem yog ib qho tseem ceeb uas yuav tau khaws ib daim ntawv teev cov tsos mob, sau lawv cov kev hloov pauv thiab txheeb xyuas cov kev xav uas cuam tshuam rau tus neeg mob. Nws yog ib qho tseem ceeb tsis txhob ntshai ntawm thawj qhov kev tawm tsam, tab sis kom meej meej ua raws li txoj kev npaj.
Tus kws kho mob tseembronchial hawb pob yog ua tib zoo kawm. Lub etiology, pathogenesis, chaw kho mob ntawm tus kab mob ua rau nws muaj peev xwm ua kom qhov tseeb kuaj mob thiab sau ntawv kho mob. Raws li txoj cai, tus kws kho mob tau sau cov tshuaj inhalers, aerosols, thiab yog tias muaj kab mob, cov tshuaj tua kab mob tau sau tseg. Raws li kev tiv thaiv kev tiv thaiv, cov lus pom zoo tseem ceeb tshaj plaws tseem yog kev cais tawm ntawm cov xwm txheej uas ua rau qaug dab peg. Txhawm rau ua qhov no, koj yuav tsum ua kom koj lub tsev huv si, zam qhov chaw qias neeg ib puag ncig, txiav luam yeeb thiab noj txhua yam tshuaj.
