哮喘联盟

   摘要
   研究目的：本综述的目的是探讨环境因素导致哮喘控制不佳的流行病学。
   最新研究发现：虽然哮喘的治疗已有很大的进步，但是仍有相当比例的患者哮喘控制不佳。儿童期哮喘的严重程度与控制情况对成年期哮喘是否发病起着至关重要的作用。儿童如合并严重过敏性鼻炎，其哮喘更加不易控制。近期的研究数据显示，老鼠而非蟑螂是城市中与哮喘关系最密切的过敏原。而烟草暴露，即便是被动暴露，也可加重哮喘症状，并降低对吸入性激素的反应。因此，公共场合的禁烟行动有利于提高整个人群的哮喘控制。家庭减排的节能行动可使室内污染水平增加，因此，必须采取行动以降低、过滤室内污染物，或加强空气对流。肥胖与哮喘控制不佳独立相关。而且，对超重的哮喘患者来说，其污染物暴露的危害更加严重。
   总结：哮喘控制不佳是多种因素综合所致，包括依从性、内在因素及环境暴露。为了进一步提高哮喘的控制率，相关的干预策略仍需更多研究。
 

（苏欣 审校）
Curr Opin Allergy Clin Immunol. 2015 Jul 29. [Epub ahead of print]

 

Difficult-to-control asthma: epidemiology and its link with environmental factors.
 

Sheehan WJ1, Phipatanakul W.
 

Abstract
PURPOSE OF REVIEW:The aim of the present review was to discuss the epidemiology of inadequate asthmacontrol with an examination of contributing environmental factors.
RECENT FINDINGS:Despite advances in asthma therapies, a proportion of patients with asthma continue to have difficulty in gaining adequate asthma control. Asthma severity and control in childhood are of particular importance as they translate to asthma morbidity in adulthood. Children with comorbid severe allergic rhinitis were more likely to have uncontrolled asthma. Recent data suggest that mouse allergen, more so than cockroach allergen, may be the most relevant urban allergen exposure. Tobacco smoke exposure, even passive exposure, leads to increased asthma symptoms and decreased response to inhaled corticosteroids. Efforts to ban smoking in public places have resulted in promising asthma results for entire populations. Energy-saving efforts to tighten a home's air leaks can lead to increased indoor pollutant levels and, therefore, must be accompanied by efforts to reduce, filter, or exchange indoor pollutants. Obesity is independently associated with decreased asthma control. Furthermore, the detrimental effects of pollutant exposure are enhanced in an overweight individual with asthma.
SUMMARY:Lack of asthma control can be because of a complex web of factors including adherence, intrinsic factors, and environmental exposures. Further research into intervention strategies is needed to achieve improved rates of asthma control.
 

Curr Opin Allergy Clin Immunol. 2015 Jul 29. [Epub ahead of print]