哮喘联盟

   摘要
   家庭医生在诊断学龄前儿童哮喘时面临很多挑战。这些诊断挑战由早期哮喘在自然史中的变化因素组成，由于幼儿喘息和哮喘是伴有多种表型和变量表达的异质性疾病，因此这些变化因素尚未被充分地理解。由于这个年龄组没有哮喘类型、严重程度或症状出现频率的标准定义，缺乏明确的基于证据的建议。如果没有适当的指南做指导，家庭医生只能自己做诊断和治疗决策，会导致哮喘的处理不足和短暂喘息的过度治疗。一些特别针对这个特定的年龄组解决哮喘诊断挑战的新指南（全球哮喘防治创仪，英国胸科协会/苏格兰校际指南网络）近期已经发表，研究人员通过流行病学研究，正积极寻求新的方法和技术以协助诊断过程中的基层医生。此综述在基层医疗中具有广泛的适用范围。通过识别诊断的挑战和了解相关最佳治疗方法，家庭医生将更好地治疗、管理和控制哮喘症状，从而降低发病率和医疗系统成本，以及提高受影响儿童的整体生活质量和身心健康。

 

（苏楠 审校）
J Am Board Fam Med. 2014 7/8;27(4):538-548.

 

Asthma in Preschool Children: A Review of the Diagnostic Challenges.
 

Cave AJ1, Atkinson LL2.
 

ABSTRACT
Family physicians face many challenges when diagnosing asthma in preschool children. These diagnostic challenges are compounded by variations in the natural history of early stage asthma, which are not fully understood, since early childhood wheezing and asthma are heterogeneous disorders with many phenotypic and variable expressions. Since no standard definition for the type, severity, or frequency of symptoms exist for this age group, clear evidence-based recommendations are lacking. Without adequate guidance, family physicians are left to make diagnostic and treatment decisions, which can lead to undertreatment of asthmatics and overtreatment of transient wheezers. New guidelines that specifically address the challenges of diagnosing asthma in this particular age group (Global Initiative for Asthma, British Thoracic Society/Scottish Intercollegiate Guidelines Network) have recently been published, and researchers are actively seeking new methods and techniques through epidemiological studies to assist primary care clinicians in the diagnostic process. This review has wide application in primary care. By recognizing the diagnostic challenges and understanding the related best practices, family physicians will be better placed to treat, manage, and control asthma symptoms, resulting in lower morbidity rates and reduced health system costs, as well as enhancing the overall quality of life and well-being of the children affected.
 

J Am Board Fam Med. 2014 7/8;27(4):538-548.