Gallucci Marcella, Carbonara Paolo, Pacilli Angela Maria Grazia, di Palmo Emanuela, Ricci Giampaolo, Nava Stefano
Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, Alma Mater Studiorum, Bologna, Italy.
Front Pediatr. 2019 Mar 5;7:54. doi: 10.3389/fped.2019.00054. eCollection 2019.
Asthma is a global problem affecting millions of people all over the world. Monitoring of asthma both in children and in adulthood is an indispensable tool for the optimal disease management and for the maintenance of clinical stability. To date, several resources are available to assess the asthma control, first is the monitoring of symptoms, both through periodic follow-up visits and through specific quality of life measures addressed to the patient in first person or to parents. Clinical monitoring is not always sufficient to predict the risk of future exacerbations, which is why further instrumental examinations are available including lung function tests, the assessment of bronchial hyper-reactivity and bronchial inflammation. All these tools may help in quantifying the future risk for each patient and therefore they potentially may change the natural history of asthmatic disease. The monitoring of asthma in children as in adults is certainly linked by many aspects, however the asthmatic child is a future asthmatic adult and it is precisely during childhood and adolescence that we should implement all the efforts and strategies to prevent the progression of the disease and the subsequent impairment of lung function. For these reasons, asthma monitoring plays a crucial role and must be particularly close and careful. In this paper, we evaluate several tools currently available for asthma monitoring, focusing on current recommendations emerging from various guidelines and especially on the differences between the monitoring in pediatric age and adulthood.
哮喘是一个全球性问题，影响着世界各地数以百万计的人。监测儿童和成人的哮喘情况是优化疾病管理和维持临床稳定不可或缺的手段。迄今为止，有多种资源可用于评估哮喘控制情况，首先是通过定期随访以及针对患者本人或其父母的特定生活质量测量方法来监测症状。临床监测并不总是足以预测未来病情加重的风险，这就是为什么还有包括肺功能测试、支气管高反应性评估和支气管炎症评估在内的进一步仪器检查。所有这些工具都有助于量化每个患者未来的风险，因此它们有可能改变哮喘疾病的自然病程。儿童和成人的哮喘监测在很多方面当然是相关联的，然而哮喘儿童长大后会成为哮喘成人，恰恰是在儿童期和青春期，我们应该全力以赴实施所有努力和策略来预防疾病进展以及随后的肺功能损害。出于这些原因，哮喘监测起着至关重要的作用，必须格外密切和谨慎。在本文中，我们评估了目前可用于哮喘监测的几种工具，重点关注各种指南中出现的当前建议，尤其是儿童期和成人期监测之间的差异。
