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遗传性血管性水肿的精选实践参数、循证治疗算法及国际指南综述

Review of Select Practice Parameters, Evidence-Based Treatment Algorithms, and International Guidelines for Hereditary Angioedema.

作者信息

Jose Jaison, Zacharias Jamie, Craig Timothy

机构信息

Penn State Milton S. Hershey Medical Center, Penn State University, 500 University Drive, P.O. Box 850, Hershey, PA, 17033, USA.

出版信息

Clin Rev Allergy Immunol. 2016 Oct;51(2):193-206. doi: 10.1007/s12016-016-8546-7.

Abstract

Hereditary angioedema (HAE) is a rare bradykinin-mediated disease that is characterized by recurrent attacks of subcutaneous or submucosal edema, which can be life threatening. HAE affects all ethnic groups equally and does not differentiate between age, sex, or race. However, the availability of therapies varies amongst countries resulting in a lack of uniformity of care. Not only is there a disparity of medication availability, but since HAE is a rare disease, it is frequently overlooked and the diagnosis is missed. Even with diagnosis, treatment and management is often less than optimal. For these reasons, it is essential to have practice parameters and guidelines. In this chapter, we focus on recent guidelines. These guidelines deal with recognition, diagnosis, medical care, patient management, and assessment, all which are essential to provide optimal care to people with a rare and orphan disease. The intent of the guidelines, and thus this chapter, is to reduce morbidity and mortality, and restore a normal quality of life for the patient with HAE. We will review the guidelines from various regions of the world as well as international group recommendations. In addition, specific patient populations such as the pregnant, elderly, and juvenile require modified treatment regimens, and for this reason, we have included these data as well. The intent of this chapter is to aid the practitioner in holistic care of the patient with HAE in order to ultimately provide the best standard of care possible.

摘要

遗传性血管性水肿(HAE)是一种罕见的由缓激肽介导的疾病,其特征为皮下或黏膜下水肿反复发作,可能危及生命。HAE对所有种族的影响相同,且不存在年龄、性别或种族差异。然而,不同国家的治疗方法可用性各不相同,导致护理缺乏统一性。不仅药物可用性存在差异,而且由于HAE是一种罕见疾病,它经常被忽视,诊断也容易漏诊。即使确诊,治疗和管理往往也不尽如人意。出于这些原因,制定实践参数和指南至关重要。在本章中,我们重点关注近期的指南。这些指南涉及识别、诊断、医疗护理、患者管理和评估,所有这些对于为患有罕见病和孤儿病的患者提供最佳护理都至关重要。指南以及本章的目的是降低发病率和死亡率,恢复HAE患者的正常生活质量。我们将回顾来自世界各个地区的指南以及国际组织的建议。此外,特定患者群体,如孕妇、老年人和青少年,需要调整治疗方案,因此,我们也纳入了这些数据。本章的目的是帮助从业者对HAE患者进行全面护理,以便最终提供尽可能最佳的护理标准。

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