Bavbek Sevim
Division of Allergic Diseases, Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
Tuberk Toraks. 2005;53(1):80-94.
Asthma is a chronic inflammatory disorder of the airways with an increasing prevalence over the last 20 years worldwide. Exacerbation of asthma is defined as rapidly progressive increase in shortness of breath, cough, wheezing, or chest tightness, or some combination of these symptoms and a decrease in expiratory airflow that can be qualified by measurement of pulmonary function such as the peak expiratory flow rate (PEFR) and FEV1. All patients with asthma are at risk of having exacerbations and it has been described previously as acute asthma, asthma or status asthmaticus. A number of medical condition such as chronic obstructive pulmonary disease (COPD), congestive heart failure, upper airway obstruction, hyperventilation syndrome, or vocal cord dysfunction may mimic the diagnosis of asthma attack, however it can be differentiated by history, physical examination, and some laboratory tests. It is a common medical emergency. The severity of exacerbations may range from mild to life threatening and immediate optimal management is of importance to prevent mortality. Morbidity and mortality are mostly related with inadequate emergency treatment and delay in referring to hospital. This review mainly focuses on the treatment of acute asthma considering the recommendations of GINA guideline.
哮喘是一种气道慢性炎症性疾病，在过去20年里全球患病率呈上升趋势。哮喘急性加重被定义为呼吸急促、咳嗽、喘息或胸闷迅速进行性加重，或这些症状的某种组合，以及呼气气流减少，这可通过测量肺功能如呼气峰值流速（PEFR）和第一秒用力呼气容积（FEV1）来判定。所有哮喘患者都有急性加重的风险，之前曾将其描述为急性哮喘、哮喘或哮喘持续状态。一些病症如慢性阻塞性肺疾病（COPD）、充血性心力衰竭、上气道梗阻、过度通气综合征或声带功能障碍可能会误诊为哮喘发作，然而可通过病史、体格检查和一些实验室检查进行鉴别。这是一种常见的医疗急症。急性加重的严重程度可从轻度到危及生命，立即进行最佳管理对于预防死亡至关重要。发病率和死亡率大多与急诊治疗不足及转诊延迟有关。本综述主要根据全球哮喘防治创议（GINA）指南的建议重点探讨急性哮喘的治疗。
