哮喘联盟

   摘要
   规律的运动有广泛的保健功效，尤其是对慢性疾病包括哮喘的管理有帮助。然而，对于某些人，运动也可以诱发哮喘急性发作并随之出现急性呼吸困难、咳嗽、胸闷和喘息。这种生理过程被称为运动诱发的支气管收缩（EIB），运动后1秒用力呼气量自基线降低10-15％。虽然EIB在哮喘患者中非常普遍，并出现与哮喘类似的呼吸道症状，但是哮喘和EIB并不相互排斥。本综述的目的是为两种情况提供一个广泛的概述，以提高对它们异同的理解，区分他们为2个不同的病症。哮喘的病理生理学和机制已经被研究很好地描述，而该方面的研究目前关注于为靶向管理策略定义表型。相反地，EIB的机制在很大程度上仍然未被描述。这两种疾病的诊断途径已经建立并且是类似的，药物和非药物治疗和管理方法已提高早期检测的成功率。鉴于运动有诱发哮喘急性发作的可能，哮喘患者常避免运动，但是目前的证据表明哮喘患者对运动有良好的耐受性并且运动能提高生活质量。目前有文献支持运动对EIB患者有利，但文献极其有限。因此，未来的研究方向应在该领域以及对EIB和哮喘的病理生理机制的进一步理解。
 

（杨冬 审校）
Respiration. 2015 Jun 11. [Epub ahead of print]

 

Asthma Bronchiale and Exercise-Induced Bronchoconstriction.
 

Jayasinghe H1, Kopsaftis Z, Carson K.
 

Abstract
Exercising regularly has a wide range of beneficial health effects; in particular, it has been well documented to help in the management of chronic illnesses including asthma. However, in some individuals, exertion can also trigger an exacerbation of asthmatic episodes and subsequent acute attacks of breathlessness, coughing, tightness of the chest and wheezing. This physiological process is called exercise-induced bronchoconstriction (EIB) whereby post-exercise forced expiratory volume in 1 s is reduced by 10-15% from baseline. While EIB is highly prevalent in asthmatics and presents with similar respiratory symptoms, asthmaand EIB are not mutually exclusive. The aim of this review is to present a broad overview of both conditions in order to enhance the understanding of the similarities and differences distinguishing them as two separate entities. The pathophysiology and mechanisms underlying asthma are well described with research now focussing on defining phenotypes for targeted management strategies. Conversely, the mechanistic understanding of EIB remains largely under-described. Diagnostic pathways for both are established and similar, as are pharmacologic and non-pharmacologic treatments and management approaches, which have enhanced success with early detection. Given the potential for exacerbation of asthma, exercise avoidance is common but counterproductive as current evidence indicates that it is well tolerated and improves quality of life. Literature supporting the benefit of exercise for EIB sufferers is at present favourable, yet extremely limited; therefore, future research should be directed in this area as well as towards further developing the understanding of the pathophysiology and mechanisms underpinning both EIB and asthma.
 

Respiration. 2015 Jun 11. [Epub ahead of print]