哮喘及慢性阻塞性肺疾病中的通气不足
2009/07/09
哮喘和COPD患者出现慢性低通气是疾病严重标志之一。该指标在预测疾病严重程度或肺功能客观指标上存在变异，其对COPD的预测的可靠性优于对哮喘的预测。COPD患者特别容易出现夜间低通气，但高危患者可以通过日间的气体交换异常进行鉴别。连续气道正压通气和无创通气尚未在哮喘患者和COPD患者中证实其缓解慢性低通气的有效性。对于CODP加重期出现的急性低通气，早期采用无创通气进行治疗不仅有效，而且能降低死亡率，减少气管插管次数和住院时间。无创通气可能对急性哮喘患者有效，但相关临床证据远少于COPD。
（陈欣 审校）
Semin Respir Crit Care Med. 2009 Jun;30(3):321-329. Epub 2009 May 18
Hypoventilation in asthma and chronic obstructive pulmonary disease.
Beuther DA.
Chronic hypoventilation is a marker of disease severity in asthma and chronic obstructive pulmonary disease (COPD). The degree to which this predicts severity or objective measures of lung function is variable, and more reliable for COPD than for asthma. Patients with COPD are particularly susceptible to nocturnal hypoventilation, but at-risk patients can be identified by abnormalities in daytime gas exchange. Continuous positive airway pressure and noninvasive ventilation have no demonstrated efficacy in the treatment of chronic hypoventilation solely due to asthma or COPD. There is consensus that early treatment with noninvasive ventilation for acute hypoventilation due to a COPD exacerbation is not only highly effective, but it reduces mortality, the need for endotracheal intubation, and hospital length of stay. There is probable benefit to the use of noninvasive ventilation in acute asthma, but the evidence to support this is far less robust than for COPD.
Chronic hypoventilation is a marker of disease severity in asthma and chronic obstructive pulmonary disease (COPD). The degree to which this predicts severity or objective measures of lung function is variable, and more reliable for COPD than for asthma. Patients with COPD are particularly susceptible to nocturnal hypoventilation, but at-risk patients can be identified by abnormalities in daytime gas exchange. Continuous positive airway pressure and noninvasive ventilation have no demonstrated efficacy in the treatment of chronic hypoventilation solely due to asthma or COPD. There is consensus that early treatment with noninvasive ventilation for acute hypoventilation due to a COPD exacerbation is not only highly effective, but it reduces mortality, the need for endotracheal intubation, and hospital length of stay. There is probable benefit to the use of noninvasive ventilation in acute asthma, but the evidence to support this is far less robust than for COPD.
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哮喘患者进行糖皮质激素吸入治疗时吸气流速的作用
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长期治疗的哮喘患者急性发作特征
