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我们应如何治疗轻度哮喘患者
How Should We Treat Patients with Mild Asthma?


Gary W.K. Wong ... 呼吸系统疾病 • 2019.05.23
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哮喘是世界上患病人数最多的慢性呼吸系统疾病之一。尽管我们对哮喘的生物学特征有了更好的了解,哮喘的治疗也取得了进展,但许多调查仍然表明世界各地大多数患者的病情控制欠佳1,2。美国和国际指南均建议对轻度间歇性哮喘患者采用短效β2受体激动剂(SABA)按需用药3,4。如果患者症状持续存在,则推荐常规应用吸入型糖皮质激素,即所谓的维持治疗,这将减少SABA的用药。在临床实践中,患者往往依靠按需用药的SABA来缓解症状,而对于吸入型糖皮质激素维持治疗的依从性相当差。最近,大约1年前于本刊发表结果的两项试验(SYGMA 1和SYGMA 2,SYMGA指的是信必可按需用药治疗轻度哮喘,Symbicort Given as Needed in Mild Asthma)对通过吸入型糖皮质激素维持疗法治疗持续性哮喘的观点提出了挑战,这两项试验表明,在预防哮喘发作方面,布地奈德-福莫特罗复方药物按需用药与布地奈德维持治疗同样有效,且前者的吸入型糖皮质激素的总用药量只有后者的几分之一5,6。然而,这一策略对轻度间歇性哮喘患者是否有效?有嗜酸性粒细胞性气道炎症的哮喘患者可能对吸入型糖皮质激素产生良好应答。无嗜酸性粒细胞性气道炎症的哮喘患者也会对吸入型糖皮质激素产生类似应答吗?本刊于这一期发表的两项试验试图回答这些重要问题。





作者信息

Gary W.K. Wong, M.D.
From the Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.

 

参考文献

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