Boulet L-P
Institut Universitaire de Cardiologie et de Pneumologie, Université Laval, 2725 Chemin Sainte-Foy, Québec, QC, Canada.
Eur Respir J. 2009 Apr;33(4):897-906. doi: 10.1183/09031936.00121308.
Various conditions such as rhinosinusitis, gastro-oesophageal reflux disease, psychological disturbances, chronic infections and obstructive sleep apnoea are often observed in asthmatic patients and may affect asthma control and outcomes. These comorbidities may change the asthma phenotype, be part of the same pathophysiological process, act as confounding factors in the diagnosis or assessment of control of asthma, and/or result from specific environmental exposures. The influences of these conditions on asthma are variable and for many of them still uncertain; nevertheless, they may alter asthma responses to current therapy. A systematic evaluation and an appropriate treatment of asthma-associated comorbid conditions should be part of asthma management, particularly for severe disease. With regard to clinical research, associated conditions may influence the results of trials and should be taken into account in the subjects' inclusion criteria and analysis of data.
哮喘患者中常可见多种情况，如鼻窦炎、胃食管反流病、心理障碍、慢性感染和阻塞性睡眠呼吸暂停，这些情况可能会影响哮喘的控制及预后。这些合并症可能会改变哮喘的表型，是同一病理生理过程的一部分，在哮喘的诊断或控制评估中作为混杂因素，和/或由特定的环境暴露引起。这些情况对哮喘的影响各不相同，其中许多影响仍不明确；然而，它们可能会改变哮喘对当前治疗的反应。对哮喘相关合并症进行系统评估和适当治疗应成为哮喘管理的一部分，尤其是对于重症患者。关于临床研究，相关情况可能会影响试验结果，在受试者纳入标准和数据分析中应予以考虑。
