Bacharier Leonard B
Department of Pediatrics, Division of Allergy and Pulmonary Medicine, Washington University School of Medicine and St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, USA.
Curr Opin Allergy Clin Immunol. 2008 Apr;8(2):158-62. doi: 10.1097/ACI.0b013e3282f64802.
The aim of this article is to review the recently published studies addressing various treatment approaches for asthma in preschool children.
The heterogeneity of wheezing in the preschool years complicates the study of asthma in this age group. Once children at highest risk for persistence of wheezing are identified, various management strategies may be thoroughly studied. Several recent studies have confirmed the efficacy and safety of both inhaled corticosteroids and leukotriene receptor antagonists in the management of early childhood asthma. In addition to examining clinical efficacy, studies investigating the effects of these treatment modalities on the underlying airway inflammation have recently increased in number and quality and confirm the anti-inflammatory actions of these therapeutic strategies in the preschool child with asthma.
Evidence for the preferred treatment strategies for persistent asthma in young children remains incomplete. Based on the current body of evidence, there is rationale for further investigation of these management strategies, including direct comparisons between inhaled corticosteroids and leukotriene receptor antagonists, as well as the role of long-acting beta-agonists, potentially targeting the subpopulations of early childhood with wheezing who are at highest risk for persistence of asthma symptoms.
本文旨在回顾近期发表的关于学龄前儿童哮喘各种治疗方法的研究。
学龄前喘息的异质性使该年龄组哮喘的研究变得复杂。一旦确定了喘息持续风险最高的儿童，就可以对各种管理策略进行全面研究。最近的几项研究证实了吸入性糖皮质激素和白三烯受体拮抗剂在幼儿哮喘管理中的有效性和安全性。除了研究临床疗效外，最近调查这些治疗方式对潜在气道炎症影响的研究在数量和质量上都有所增加，并证实了这些治疗策略对学龄前哮喘儿童的抗炎作用。
关于幼儿持续性哮喘首选治疗策略的证据仍然不完整。基于目前的证据，有理由进一步研究这些管理策略，包括吸入性糖皮质激素和白三烯受体拮抗剂之间的直接比较，以及长效β受体激动剂的作用，可能针对喘息的幼儿亚群，这些亚群哮喘症状持续的风险最高。
