DeBaun Michael R, Strunk Robert C
Department of Pediatrics and Medicine, Division of Hematology/Oncology, Nashville, TN, USA; Vanderbilt-Meharry Sickle Cell Center for Excellence, Vanderbilt University School of Medicine, Nashville, TN, USA.
Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
Lancet. 2016 Jun 18;387(10037):2545-53. doi: 10.1016/S0140-6736(16)00145-8.
Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies. Although understanding has increased about asthma as a comorbidity in sickle-cell disease and its effects on morbidity, substantial gaps remain in knowledge about best management.
急性胸综合征是镰状细胞病患儿急性肺病的常见病因。哮喘在镰状细胞病患儿中很常见，并且与血管阻塞性疼痛事件、急性胸综合征发作的发生率增加以及过早死亡有关。哮喘加重和急性胸综合征发作的危险因素相似，两者都可能表现为呼吸急促、胸痛、咳嗽和喘息。尽管存在重叠的危险因素和症状，但哮喘急性加重或急性胸综合征发作是两个不同的实体，需要针对疾病的管理策略。虽然对哮喘作为镰状细胞病的合并症及其对发病率的影响的认识有所增加，但在最佳管理方面的知识仍存在很大差距。
