Simon Arne, Schildgen Oliver
Children's Hospital, Medical Centre, University of Bonn, Bonn, Germany.
Treat Respir Med. 2006;5(4):255-69. doi: 10.2165/00151829-200605040-00004.
There is an increasing number of viral and bacterial pathogens suspected of contributing to asthma pathogenesis in childhood, making it more difficult for the practitioner to make specific therapy decisions. This review discusses the role of viruses, e.g. respiratory syncytial virus, human metapneumovirus, influenza viruses and rhinoviruses, as well as the role of the atypical bacteria Chlamydophila pneumoniae and Mycoplasma pneumoniae, as contributors to childhood asthma. Diagnosis, prevention, and therapy are discussed, including a summary of drugs, i.e. macrolide antibacterials, antivirals, and vaccine regimens already available, or at least in clinical trials. For the practitioner dealing with patients every day, drug regimens are assigned to the individual pathogens and an algorithm for the management of atypical infections in patients with asthma or recurrent wheezing is presented.
越来越多的病毒和细菌病原体被怀疑与儿童哮喘的发病机制有关,这使得从业者更难做出具体的治疗决策。本综述讨论了病毒,如呼吸道合胞病毒、人偏肺病毒、流感病毒和鼻病毒的作用,以及非典型细菌肺炎衣原体和肺炎支原体作为儿童哮喘致病因素的作用。文中讨论了诊断、预防和治疗方法,包括对现有或至少正在临床试验中的药物,即大环内酯类抗菌药物、抗病毒药物和疫苗方案的总结。对于每天接诊患者的从业者,文中将药物治疗方案与个体病原体相对应,并给出了哮喘或反复喘息患者非典型感染的管理算法。