超重哮喘儿童与非超重哮喘儿童生活质量与健康状况的对比哮喘和阻塞性睡眠呼吸暂停重叠：证据告诉我们什么？
2020/01/07
摘要
阻塞性睡眠呼吸暂停（OSA）和哮喘是高度流行的慢性呼吸系统疾病。除了因其高患病率和共同的危险因素而导致的频繁共存外，这些疾病还具有相互影响的功能，每种疾病都会影响另一种疾病的严重性。越来越多的证据表明，气道和全身炎症，神经免疫相互作用以及哮喘控制药物（皮质类固醇）的影响是使哮喘患者易患OSA的因素。相反，未诊断或治疗不充分的OSA会对哮喘控制产生不利影响，部分原因是间歇性缺氧对气道炎症和组织重塑的影响。在本文中，我们回顾了最近发表的支持这种相互作用的证据。我们为参与成人哮喘护理的临床医生提供了一系列建议，最后，确定了对于增进我们对这种重叠的理解至关重要的知识空白。
Asthma and Obstructive Sleep Apnea Overlap: What has the Evidence Taught Us.
Prasad B, Nyenhuis SM, Imayama I, Siddiqi A, Teodorescu M.
Abstract
Obstructive sleep apnea (OSA) and asthma are highly prevalent chronic respiratory disorders. Beyond frequent coexistence arising from their high prevalence and shared risk factors, these disorders feature a reciprocal interaction, whereby each disease impacts the severity of the other. Emerging evidence implicates airway and systemic inflammation, neuroimmune interactions, as well as effects of asthma-controlling medications (corticosteroids) as factors predisposing patients with asthma to OSA. Conversely, undiagnosed or inadequately treated OSA adversely affects asthma control, partly via effects of intermittent hypoxia on airway inflammation and tissue remodeling. In this article, we review the recently published evidence supporting this interaction. We provide a set of recommendations for clinicians involved in adult asthma care and finally, identify knowledge gaps critical to advancing our understanding of this overlap.
.
阻塞性睡眠呼吸暂停（OSA）和哮喘是高度流行的慢性呼吸系统疾病。除了因其高患病率和共同的危险因素而导致的频繁共存外，这些疾病还具有相互影响的功能，每种疾病都会影响另一种疾病的严重性。越来越多的证据表明，气道和全身炎症，神经免疫相互作用以及哮喘控制药物（皮质类固醇）的影响是使哮喘患者易患OSA的因素。相反，未诊断或治疗不充分的OSA会对哮喘控制产生不利影响，部分原因是间歇性缺氧对气道炎症和组织重塑的影响。在本文中，我们回顾了最近发表的支持这种相互作用的证据。我们为参与成人哮喘护理的临床医生提供了一系列建议，最后，确定了对于增进我们对这种重叠的理解至关重要的知识空白。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Am J Respir Crit Care Med. 2019 Dec 16. doi: 10.1164/rccm.201810-1838TR.)
(Am J Respir Crit Care Med. 2019 Dec 16. doi: 10.1164/rccm.201810-1838TR.)
Asthma and Obstructive Sleep Apnea Overlap: What has the Evidence Taught Us.
Prasad B, Nyenhuis SM, Imayama I, Siddiqi A, Teodorescu M.
Abstract
Obstructive sleep apnea (OSA) and asthma are highly prevalent chronic respiratory disorders. Beyond frequent coexistence arising from their high prevalence and shared risk factors, these disorders feature a reciprocal interaction, whereby each disease impacts the severity of the other. Emerging evidence implicates airway and systemic inflammation, neuroimmune interactions, as well as effects of asthma-controlling medications (corticosteroids) as factors predisposing patients with asthma to OSA. Conversely, undiagnosed or inadequately treated OSA adversely affects asthma control, partly via effects of intermittent hypoxia on airway inflammation and tissue remodeling. In this article, we review the recently published evidence supporting this interaction. We provide a set of recommendations for clinicians involved in adult asthma care and finally, identify knowledge gaps critical to advancing our understanding of this overlap.
.
