Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Ontario.
Can Respir J. 2013 Mar-Apr;20(2):117-20. doi: 10.1155/2013/602936.
Airway inflammation is a central feature of many airway diseases such as asthma, chronic bronchitis, bronchiectasis and chronic cough; therefore, it is only logical that it is measured to optimize its treatment. However, most treatment recommendations, including the use of anti-inflammatory therapies such as corticosteroids, are based on assessments of only airflow and symptoms. Over the past 10 years, methods have been developed to assess airway inflammation relatively noninvasively. Quantitative cell counts in sputum and the fraction of exhaled nitric oxide are the most validated tests. Judicious use of currently available drugs, such as corticosteroids, bronchodilators and antibiotics, and other anti-inflammatory therapies guided by sputum eosinophil and neutrophil counts, have been demonstrated to decrease exacerbations of asthma and chronic obstructive pulmonary disease, ameliorate cough, improve quality of life in patients with these diseases and is cost effective compared with treatment strategies based on guidelines that do not incorporate these measurements. Thus, it is unfortunate that this is not used more widely in the management of airway diseases, particularly in patients with severe asthma and chronic obstructive pulmonary disease who experience frequent exacerbations.
气道炎症是许多气道疾病（如哮喘、慢性支气管炎、支气管扩张和慢性咳嗽）的核心特征；因此，为了优化治疗效果而对其进行测量是合理的。然而，大多数治疗建议，包括使用皮质类固醇等抗炎疗法，都是基于对气流和症状的评估。在过去的 10 年中，已经开发出了相对非侵入性的气道炎症评估方法。痰中细胞计数和呼出气一氧化氮分数是最经过验证的测试。明智地使用目前可用的药物，如皮质类固醇、支气管扩张剂和抗生素，以及其他根据痰中嗜酸性粒细胞和中性粒细胞计数指导的抗炎疗法，已被证明可以减少哮喘和慢性阻塞性肺疾病的恶化，减轻咳嗽，改善这些疾病患者的生活质量，并且与不包括这些测量的基于指南的治疗策略相比具有成本效益。因此，令人遗憾的是，这在气道疾病的管理中并没有得到更广泛的应用，特别是在经常发生恶化的严重哮喘和慢性阻塞性肺疾病患者中。
