哮喘联盟

   摘要
   哮喘是以气道可变性狭窄、间歇性呼吸困难、喘息及夜间或清晨咳嗽为特点的慢性呼吸道炎症性疾病。全世界现有3亿1千5百万各年龄层次的哮喘患者，哮喘俨然已成为全球主要健康问题。哮喘临床表现多样，病理生理机制复杂。为方便起见，常根据峰流速值（该数值代表肺功能受损等级）将哮喘患者行动计划分成3类区域：绿色，黄色和红色。近来有证据表明，每个程度的哮喘症状（无论其处于哪块区域，包括绿色区）均有可能发生哮喘严重发作的潜在风险。另外，在现实生活中，哮喘患者对症状认识不足或对自我监管哮喘能力的高估，均可能掩盖病情并导致症状的突然加重。了解如何应对这些患者，以及评估他们的远期风险，可显著改善临床治疗结果及预后。根据一些专注于轻度哮喘临床监控的医生最近发表的建议和思考，我们希望明确最轻度哮喘在日常监控上的可加强及不足之处，以着重探寻绿色区域哮喘患者在诊断及治疗策略上的其他选择。

 

（苏楠 审校）
Minerva Med. 2014 Jul 4. [Epub ahead of print]

 

Is mild asthma in real life always in the Green Zone?
 

Patella V1, Santus P, Puggioni F, Steinhilber G, Scichilone N.
 

ABSTRACT
Asthma is a chronic inflammatory disease of the airways that is characterized by variable narrowing of the airways and symptoms of intermittent dyspnea, wheezing, and nighttime or early-morning coughing. Asthma is a major health problem throughout the world, affecting an estimated 315 million persons of all ages. Asthma is clinically heterogeneous, and its pathophysiology is complex. For convenience, asthma action plans are often broken down into three zones, usually based on peak flow meter recordings: green, yellow, and red according to the level of lung function impairment. Recent evidence shows that every asthmatic is potentially at risk for severe exacerbation independently of his/her zone, including the green zone. Furthermore, in real life scenario asthmatic patients can have poor perception of their symptoms or/and overestimate their level of asthma control, and this can obviously confound the clinical picture and favor sudden worsening of symptoms. To understand how to treat these patients, as well as how to assess their future risk, can make a difference in terms of clinical outcomes and prognosis. Following the suggestions and concerns recently published, who recently focused on the clinical management of mild asthma, we aimed at exploring strengthens and gaps in the daily management of the mildest forms of the disease, with a focus on alternative diagnostic and therapeutic strategies in approaching the "green" patient in clinical practice.

Minerva Med. 2014 Jul 4. [Epub ahead of print]