Wenzel Sally
National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA.
Mt Sinai J Med. 2003 May;70(3):185-90.
Severe asthma is poorly understood clinically, physiologically and pathologically. Whereas milder forms of asthma are generally easily treated, more severe forms often remain refractory to the best current medical care. Although some asthmatics have been severely affected for most of their lives, there appears to be a second group that develops severe disease in adulthood. Additionally, it is not clear which genetic and environmental elements may be most important in the development of severe disease. Physiologically, these patients often have airtrapping and may have loss of elastic recoil, as well. The pathology demonstrates a heterogeneity of findings, including continued eosinophilic inflammation, structural changes, and distal disease. Treatment is problematic and will probably remain so until a better understanding of this disease develops.
重度哮喘在临床、生理和病理方面都尚未被充分理解。较轻形式的哮喘通常易于治疗，而更严重的形式往往对当前最佳医疗护理仍具难治性。虽然一些哮喘患者一生中大部分时间都受到严重影响，但似乎还有另一组患者在成年期患上严重疾病。此外，尚不清楚哪些遗传和环境因素在严重疾病的发展中可能最为重要。在生理上，这些患者常常存在气体潴留，并且可能也有弹性回缩丧失。病理学显示出各种不同的发现，包括持续的嗜酸性粒细胞炎症、结构改变和远端疾病。治疗存在问题，并且在对这种疾病有更好的理解之前可能仍会如此。
