Zorc J J, Pawlowski N A
University of Pennsylvania School of Medicine, Department of Pediatrics, The Children's Hospital of Philadelphia, 19104, USA.
Curr Opin Pediatr. 2000 Oct;12(5):438-43. doi: 10.1097/00008480-200010000-00003.
Asthma prevalence has risen substantially in recent decades and is an increasing cause of disability for American children. Concern about the rise in morbidity has led to treatment guidelines and a growing body of clinical research. Recent trials continue to support the role of inhaled corticosteroids as the most effective therapy to control airway inflammation associated with persistent asthma. Growth suppression due to inhaled corticosteroids has also been well documented, although the long-term effects and relative potencies of different agents require further study. Other anti-inflammatory agents such as cromolyn and the new class of leukotriene receptor antagonists have demonstrated benefit in milder patients. Leukotriene receptor antagonists and long-acting beta2-agonists may allow for reduction of inhaled steroid doses. Control of environmental allergens and irritants is essential. New evidence suggests an increasingly important role for allergen immunotherapy.
近几十年来，哮喘的患病率大幅上升，并且日益成为美国儿童残疾的一个原因。对发病率上升的担忧催生了治疗指南以及越来越多的临床研究。近期的试验继续支持吸入性糖皮质激素作为控制与持续性哮喘相关的气道炎症的最有效疗法的作用。吸入性糖皮质激素导致生长抑制也有充分的文献记载，尽管不同药物的长期影响和相对效力需要进一步研究。其他抗炎药物，如色甘酸钠和新型白三烯受体拮抗剂，已在病情较轻的患者中显示出益处。白三烯受体拮抗剂和长效β2激动剂可能有助于减少吸入性类固醇药物的剂量。控制环境过敏原和刺激物至关重要。新证据表明变应原免疫疗法的作用越来越重要。
