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[过敏反应。]

[Anaphylaxis.].

作者信息

Bjœrnsdóttir Unnur Steina, Sigurðardóttir Sigurveig Thorn, Lúðvíksson Bjœrn Rúnar

机构信息

Laboratory of Immunology, Landspitali University Hospital, Hringbraut, 101 Reykjavík, Iceland.

出版信息

Laeknabladid. 2002 Jul-Aug;88(7-8):551-9.

Abstract

Anaphylaxis is a life threatening medical emergency in which the possibility for patient morbidity and mortality is high. It is the most serious of allergic disorders. An understanding of the pathophysiology of anaphylaxis and recognition of symptoms is paramount for its diagnosis. The term anaphylaxis refers to a generalized allergic reaction that results from a type I immunologic reaction. IgE activation of mast cells and basophils results in the release of preformed mediatiors including histamine, prostaglandins, and leukotrienes. These mediators induce vascular permeability, vascular smooth muscle relaxation and constriction of bronchial smooth muscles. Anaphylactoid reactions are clinically and pathologically similar but are not IgE mediated. This pathophysiologic sequence of events leads to the clinical manifestations of anaphylaxis including urticaria, angioedema, pruritus, and bronchospasms, eventually leading to hypotension and death if left untreated. This article discusses current demographics, causes and pathophysiology of anaphylaxis and provides guidelines for the treatment of anaphylaxis. The importance of prompt and correct treatment with adrenaline as well as thorough medical evaluation is also reviewed.

摘要

过敏反应是一种危及生命的医疗急症,患者出现发病和死亡的可能性很高。它是最严重的过敏性疾病。了解过敏反应的病理生理学并识别症状对于其诊断至关重要。过敏反应一词指的是由I型免疫反应引起的全身性过敏反应。肥大细胞和嗜碱性粒细胞的IgE激活导致预先形成的介质释放,包括组胺、前列腺素和白三烯。这些介质诱导血管通透性增加、血管平滑肌舒张以及支气管平滑肌收缩。类过敏反应在临床和病理上相似,但不是由IgE介导的。这种病理生理事件序列导致过敏反应的临床表现,包括荨麻疹、血管性水肿、瘙痒和支气管痉挛,如果不治疗最终会导致低血压和死亡。本文讨论了过敏反应的当前人口统计学、病因和病理生理学,并提供了过敏反应的治疗指南。还回顾了及时正确使用肾上腺素治疗以及全面医学评估的重要性。

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