Department of Pediatrics, Children's Center Bethel, Evangelical Hospital Bethel, Bielefeld, Germany.
Allergy Center, Ruhr-University, Bochum, Germany.
Pediatr Allergy Immunol. 2020 Apr;31(3):233-242. doi: 10.1111/pai.13175. Epub 2019 Dec 11.
There is growing concern regarding the long-term outcomes of early and poorly controlled childhood asthma, either of which can potentially lead to the development of severe asthma in adults and irrecoverable loss of lung function leading to chronic obstructive pulmonary disease. These outcomes of inadequately controlled asthma should prompt a change in practice to better and/or earlier identify children at risk of adverse respiratory outcomes of asthma, to monitor disease progression, and to design intervention strategies that could either prevent or reverse asthma progression in children. The careful follow-up of spirometry over time-in the form of lung function trajectories, the application of biomarkers to assist in the diagnosis of early asthma and medication selection for these patients, as well as methods to identify patients at risk of asthma attacks-can be used to develop individualized management strategies for children with asthma. It is now time for asthma specialists to communicate this information to patients, parents, and primary care physicians and to incorporate them into routine clinical assessments of children with asthma. In time, these concepts of risk management and prevention can be refined to provide a more comprehensive approach to asthma care so as to prevent adverse respiratory outcomes from poorly controlled childhood asthma.
人们越来越关注儿童时期早期控制不佳的哮喘的长期后果，这两者都可能导致成年人患严重哮喘，并不可逆转地丧失肺功能，进而导致慢性阻塞性肺疾病。这些控制不佳的哮喘的后果应该促使实践发生改变，以便更好地和/或更早地识别出有不良呼吸后果风险的哮喘儿童，监测疾病进展，并设计干预策略，以预防或逆转儿童哮喘的进展。随着时间的推移，通过肺功能轨迹来仔细跟踪肺活量计，应用生物标志物来辅助早期哮喘的诊断和这些患者的药物选择，以及识别哮喘发作风险患者的方法，可以用于为哮喘儿童制定个体化的管理策略。现在是哮喘专家向患者、家长和初级保健医生传达这些信息的时候了，并将其纳入哮喘儿童的常规临床评估中。随着时间的推移，这些风险管理和预防的概念可以得到完善，为哮喘护理提供更全面的方法，以防止控制不佳的儿童哮喘产生不良的呼吸后果。
