Mechanics of airway narrowing.
Mechanics of airway narrowing.
复制标题
气道变窄的机制。
DOI：
10.1164/arrd.1986.133.6.1171
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
P. Paré
中科院分区：
文献类型：
--
作者：
R. Moreno;J. Hogg;P. Paré
在他的经典著作第一版中，奥斯勒（1）列出了几种关于哮喘病因的理论，其中包括（7）支气管肌肉痉挛，（2）支气管粘膜肿胀，（5）小细支气管炎症。他指出，花粉热发作时鼻粘膜的变化与哮喘患者支气管的变化有相似之处。他认为，充血肿胀的支气管粘膜渗出物可以解释呼吸障碍。他认为，这些变化可能是由于支气管粘膜的直接刺激，也可能是由于鼻粘膜和其他部位受到刺激后的反射引起的，在哮喘受试者中发生的与特异性和非特异性刺激有关的过度气道狭窄似乎已经被奥斯勒清楚地理解。从那时起，关于平滑肌收缩和气道壁水肿对管腔狭窄的作用已经有很多报道。关于气道组织中肥大细胞、嗜酸性粒细胞和其他细胞释放炎症介质的研究已经很多。这些介质中的许多有助于炎症反应的流体渗出和细胞组分，以及平滑肌收缩。本文的目的是试图了解气道结构和气道平滑肌收缩的变化如何导致气道狭窄。
In the first edition of his classic text, Osler (1) listed several theories concerning the cause of asthma, which included (7) spasm of the bronchial muscles,(2) swelling of the bronchial mucous membrane, and (5) inflammation of the smaller bronchioles. He pointed out the similarities between the changes that occurred in the nasal mucous membranes in an attack of hay fever and those found in bronchi in asthmatics. He suggested that the exudation from a hyperemic swollen bronchial mucosa could explain the hindrance to respiration. He thought that those changes could either be by direct irritation of the bronchial mucosa or be induced by reflexes following stimulation of the nasal mucosa and other sites.The excessive airway narrowing that occurs in asthmatic subjects in relation to both specific and nonspecific stimuli seems to have been clearly understood by Osler. Since then, much has been written about the contribution of smooth muscle contraction and edema of the airway wall to the narrowing of the lumen. Much more has been written about the release of inflammatory mediators from mast cells and eosinophils and other cells within the airway tissue. Many of these mediators contribute to fluid exudative and cellular components of the inflammatory response, as well as to the smooth muscle contraction. The purpose of this article is to try to understand how changes in airway structure and airway smooth muscle contraction bring about airway narrowing.