Small bronchial smooth muscle contracture

Introduction Small bronchial smooth muscle contracture is one of the major pathological changes in type I hypersensitivity diseases. Diseases associated with type I hypersensitivity reactions include atopic disease allergic rhinitis, allergic conjunctivitis, atopic dermatitis, and allergic asthma (exogenous and some urticaria, gastrointestinal food reactions, and systemic allergies) reaction).

Cause

Atopic diseases (including atopic dermatitis) have a genetic quality. The patient develops a hypersensitivity reaction mediated by IgE antibodies to substances inhaled or ingested (allergens), and these substances are not harmful to people without atopic diseases. In addition to atopic dermatitis, IgE antibodies usually mediate hypersensitivity reactions. In infants and young children, although the symptoms of atopic dermatitis are caused by IgE-mediated food allergies, the symptoms of dermatitis in older children and adults are largely independent of allergic factors, although most patients still maintain specific allergies. .

an examination

First, the symptoms

(1) Hay fever, that is, hay fever, also known as allergic rhinitis, is mainly caused by inhalation of plant pollen sensitization, so it has seasonal and regional characteristics. The clinical manifestations of the disease are mainly in the nose, eyes and respiratory tract. Examination revealed pale edema of the nasal mucosa and conjunctival hyperemia. It is not difficult to diagnose according to the symptoms and skin test results of pollen infusion. Antihistamines can significantly control clinical symptoms, and can also be used in the nasal and ocular areas of steroids and mast cell stabilizers such as disodium cromoglycate. Desensitization treatment before pollen season can often receive better results.

(B) bronchial asthma is a broad and reversible airway stenosis disease caused by allergen or other factors caused by bronchial hyperresponsiveness. The incidence rate in Beijing, China is about 5%, which is an important respiratory disease in pediatrics and internal medicine. Occurs in children and young adults, with a clear family history. The disease is prolonged, the course of disease is longer, the frequency is sensitive, and there are more complications. In the United States, about 2,000 to 3,000 deaths from asthma each year, and there is an increasing trend. The factors that cause asthma are very complex, and inhalation and ingestive allergens, as well as infections, especially respiratory viral infections, are important causes of asthma. The main pathological changes are small bronchial smooth muscle contracture, telangiectasia, increased permeability, small bronchial mucosal edema, increased mucosal gland secretion, mucus plug formation, and thus narrowed airway, patients feel chest tightness, difficulty breathing. These pathological changes and symptoms are mainly the result of LTs and histamine effects. Although great progress has been made in the classification, differential diagnosis, prevention and prognosis of bronchial asthma, there are still many problems to be solved.

(C) atopic dermatitis, also known as atopic dermatitis, is a common skin allergic disease, about 70% of patients have a positive family history. Most patients have elevated serum IgE levels. The lesion is mainly rash, characterized by intense itching. The pathological changes in the acute phase are interstitial edema and epithelial herpes formation. The superficial dermis may have edema, vasodilation and infiltration of lymphocytes and eosinophils. In the subacute stage, there are vesicles and keratinization in the epidermis, and a large amount of lymphocytes infiltrate. Chronic atopic dermatitis mainly manifests keratinization and hyperplasia of the epidermis, thickening of the skin, lichenification, infiltration of a large number of inflammatory cells around the blood vessels, and often pigmentation. The rash occurs in the elbow fossa, armpits, neck and face. The disease can be divided into infant, child and adult. Infants' atopic dermatitis, also known as infant eczema, occurs more frequently from April to June after birth. The lesions are both exudative and dry. The adult type is mostly in the adolescent stage, which is characterized by a generalized flattened papule, thickened skin and mossy skin. Atopic dermatitis is sensitive to physicochemical and other stimuli. Most patients have intermittent attacks and are prone to recurrence in winter. Diagnosis is based primarily on typical skin manifestations and positive family history.

(4) Food allergies generally occur from a few minutes to an hour after eating. Symptoms include erythema, lip swelling, oral pain, glossopharyngeal, nausea, and vomiting. Common foods that cause allergies in young children are eggs, milk, fish and nut nuts.

Second, diagnosis

Judgment can be made based on medical history, clinical manifestations, and laboratory data.

Differential diagnosis

diagnosis

Judgment can be made based on medical history, clinical manifestations, and laboratory data.

Differential diagnosis

Bronchospasm: a disease commonly seen in the respiratory department, mainly diseases such as bronchitis. Smoking-induced asthma is mainly determined by various harmful components such as tar, nicotine and hydrogen cyanide contained in the smoke. Nicotine and the like can act on autonomic nerves, which can stimulate the vagus nerve and cause bronchospasm. Bronchospasm, poor ventilation, manifested as difficulty breathing, asthma, hypoxia, severe suffocation and death.

Small bronchial mucosal edema: There are inflammatory lesions, edema of the small bronchial mucosa, common in the lungs. Pulmonary bullae are generally secondary to inflammatory lesions in the bronchioles. Such as pneumonia, emphysema and tuberculosis, the most common clinical and emphysema. Pulmonary bullae secondary to pneumonia or lung abscesses are more common in infants and young children, there are single and multiple.

Bronchial smooth muscle spasm: bronchial asthma is referred to as asthma, and the main pathological change is bronchial smooth muscle spasm, which is one of the common respiratory diseases in pediatrics. It is currently believed that bronchial asthma is a chronic airway inflammatory disease, and many cells play important roles in it, such as lymphocytes, eosinophils, mast cells, etc., accompanied by a significant increase in non-specific airway response. Airway hyperresponsiveness (BHR) is a multifactorial disease with major clinical features. Clinically, it mainly manifests as reversible wheezing and coughing episodes, chest tightness, and difficulty in breathing. These symptoms are often reversible, but they can also cause death.

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