轻度哮喘：流行病学、临床特征及治疗建议的专家回顾
2007/10/26
2007年6月在《Allergy》发表了一篇由巴黎11位肺科专家、4位儿科医生、1位药理学家和1位全科医生组成的工作组共同完成关于轻度哮喘的文章：“轻度哮喘：流行病学、临床特征及治疗建议的专家回顾”。作者们认为轻度哮喘困扰着50％～75％的哮喘患者，儿童比成人更常见，且不易控制。轻度哮喘可导致病情加重，发生率约为每年患者12％～77%，其中30％～40％的患者需要急诊处理。轻度哮喘时炎症及结构重塑持续存在，严重程度不定，缺乏特异性。吸入糖皮质激素可减轻炎症，但对结构重塑影响很小，一旦停药，炎症随之出现。长期低剂量吸入糖皮质激素是目前公认的治疗轻度持续性哮喘的方法。其疗效要在治疗3个月后重新进行评估，如疗效不满意，应升级治疗，并不再考虑为轻度哮喘。由于轻度哮喘是哮喘最常见的表现形式，其诊断和治疗尤需临床医生注意。
(黄春雷 首都儿科研究所哮喘中心 100020 摘译)
（Allergy 62 (6)： 591–604)
Mild Asthma :an Expert Review on Epidemiology ,Clinical Characteristics and Treatment Recommendations
D.Dusser,D.Montani,P.Chanez,J.deBlic,C.Delacourt,.Deschildre,P.devillier,
A.Didier,CLeroyer,C.Marguet,Y.Martinat,J.Piquet,C.Raherison,P.Serrier,
I.Tillie-Leblond. A..-B. Tonnel, M.T.de Lara, M.Humbert
Abstract 摘要
This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and less well controlled in children than in adults. Cohort studies from childhood to adulthood show that asthma severity usually remains stable over time. Nevertheless, mild asthma can lead to severe exacerbations, with a frequency ranging from 0.12 to 0.77 per patient-year. Severe exacerbations in mild asthma represent 30–40% of asthma exacerbations requiring emergency consultation. In mild asthma, inflammation and structural remodelling are constant, of varying intensity, but nonspecific. Therapy with inhaled corticosteroids (ICS) decreases bronchial inflammation, but has only a slight effect on structural remodelling, and, when stopped, inflammation immediately recurs. Permanent low-dose ICS therapy is the reference treatment for persistent mild asthma. Effectiveness is to be reassessed at 3 months, and if it is insufficient the patient is no longer considered mildly asthmatic, and treatment has to be stepped up. As mild asthma is the most frequent form of the disease, diagnosis and management require physicians’ particular attention.
Key words: clinical signs;epideniology;mild ashma;physiopathology;treatment.
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早期应用抗生素可增加儿童哮喘患病几率
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