Krčmová Irena, Novosad Jakub
Vnitr Lek. 2019 Winter;65(2):149-156.
Anaphylactic symptoms and anaphylactic shock are serious, rapidly developing and potentially fatal systemic reactions occurring after contact with the trigger, followed by release of a number of substances that affect vascular permeability, smooth muscle tone of blood vessels and bronchi with activation of the systemic inflammatory cascade. From a pathophysiological point of view, it can be an IgE-mediated immune response followed by massive release of biologically active mediators from mast cells and basophils (IgE dependent). If the mastocyt/basophil is degranulated via a direct IgE-free pathway, it is non-allergic (non-IgE dependent, anaphylactoid anaphylaxis). The diagnosis of anaphylaxis is determined on the basis of clinical criteria, taking into account the need to initiate therapy in a life-threatening condition without delay. Adrenaline is the first-line drug in the treatment of anaphylaxis and there is no contraindication to its use. Early provision of venous intake is essential for the patient to develop hypotension.
过敏症状和过敏性休克是在接触触发因素后发生的严重、迅速发展且可能致命的全身反应,随后会释放多种影响血管通透性、血管和平滑肌张力以及激活全身炎症级联反应的物质。从病理生理学角度来看,它可以是一种IgE介导的免疫反应,随后肥大细胞和嗜碱性粒细胞大量释放生物活性介质(IgE依赖型)。如果肥大细胞/嗜碱性粒细胞通过直接的非IgE途径脱颗粒,则为非过敏性(非IgE依赖型,类过敏性过敏反应)。过敏反应的诊断基于临床标准,同时考虑到在危及生命的情况下需要立即开始治疗。肾上腺素是治疗过敏反应的一线药物,且使用时无禁忌证。对于出现低血压的患者,尽早建立静脉通路至关重要。