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哮喘控制:如何进行最佳评估?

Asthma control: how it can be best assessed?

机构信息

aRespiratory Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China bPriority Research Centre for Asthma and Respiratory Diseases, School of Health and Medicine cSchool of Nursing and Midwifery, University of Newcastle dDepartment of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.

出版信息

Curr Opin Pulm Med. 2014 Jan;20(1):1-7. doi: 10.1097/MCP.0000000000000003.

Abstract

PURPOSE OF REVIEW

A control-based asthma assessment is recommended by guidelines, but questions remain about how to assess the level of asthma control, and how current control status relates to future risks and biomarkers of disease pathogenesis. This review summarizes recent published data relating to asthma control and describes the challenges created by currently available instruments.

RECENT FINDINGS

The current literature continues to show the widespread use of various assessment instruments for asthma control, in particular those with composite scores. However, poor correlations exist between the different assessment tools, and these instruments lack diagnostic accuracy to differentiate uncontrolled asthma. Whereas the concept of asthma control has been extended to add an assessment of future risks to the clinical control, clinical asthma control as measured by current available assessment tools does not necessary relate to the intrinsic disease activity which is typically characterized by inflammation in asthma.

SUMMARY

The application of asthma control assessment represents an improvement in asthma management. The measurement of underlying disease activity potentially by biomarkers to assess disease control will lead to an improved assessment of the overall control of asthma, and further studies addressing this are needed.

摘要

目的综述

指南推荐基于控制的哮喘评估,但仍存在一些问题,例如如何评估哮喘控制水平,以及当前的控制状况与未来的风险和疾病发病机制的生物标志物之间的关系。本综述总结了与哮喘控制相关的最新发表数据,并描述了当前可用仪器带来的挑战。

最近的发现

目前的文献继续显示出广泛使用各种哮喘控制评估工具,特别是那些具有综合评分的工具。然而,不同的评估工具之间存在较差的相关性,并且这些仪器缺乏区分未控制哮喘的诊断准确性。尽管哮喘控制的概念已经扩展到将未来风险的评估纳入临床控制,但目前可用评估工具测量的临床哮喘控制并不一定与内在疾病活动相关,而内在疾病活动通常以哮喘中的炎症为特征。

总结

哮喘控制评估的应用代表了哮喘管理的改进。通过生物标志物来测量潜在的疾病活动以评估疾病控制,将有助于更全面地评估哮喘的整体控制,并且需要进一步研究来解决这个问题。

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