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哮喘

Asthma.

作者信息

Porsbjerg Celeste, Melén Erik, Lehtimäki Lauri, Shaw Dominick

机构信息

Department of Respiratory and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet and Sachs' Children and Youth Hospital, Stockholm, Sweden.

出版信息

Lancet. 2023 Mar 11;401(10379):858-873. doi: 10.1016/S0140-6736(22)02125-0. Epub 2023 Jan 19.

Abstract

Asthma is one of the most common chronic non-communicable diseases worldwide and is characterised by variable airflow obstruction, causing dyspnoea and wheezing. Highly effective therapies are available; asthma morbidity and mortality have vastly improved in the past 15 years, and most patients can attain good asthma control. However, undertreatment is still common, and improving patient and health-care provider understanding of when and how to adjust treatment is crucial. Asthma management consists of a cycle of assessment of asthma control and risk factors and adjustment of medications accordingly. With the introduction of biological therapies, management of severe asthma has entered the precision medicine era-a shift that is driving clinical ambitions towards disease remission. Patients with severe asthma often have co-existing conditions contributing to their symptoms, mandating a multidimensional management approach. In this Seminar, we provide a clinically focused overview of asthma; epidemiology, pathophysiology, diagnosis, and management in children and adults.

摘要

哮喘是全球最常见的慢性非传染性疾病之一,其特征为气流受限多变,可导致呼吸困难和喘息。目前已有高效的治疗方法;在过去15年里,哮喘的发病率和死亡率已大幅改善,大多数患者能够实现良好的哮喘控制。然而,治疗不足的情况仍然普遍,提高患者和医护人员对何时以及如何调整治疗的认识至关重要。哮喘管理包括对哮喘控制情况和风险因素进行评估,并据此调整药物的循环过程。随着生物疗法的引入,重度哮喘的管理已进入精准医学时代——这一转变推动了实现疾病缓解的临床目标。重度哮喘患者通常并存一些导致其症状的疾病,这就需要采取多维度的管理方法。在本研讨会上,我们将针对哮喘,提供一份聚焦临床的概述,内容包括儿童和成人哮喘的流行病学、病理生理学、诊断及管理。

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