Porsbjerg Celeste, Melén Erik, Lehtimäki Lauri, Shaw Dominick
Department of Respiratory and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet and Sachs' Children and Youth Hospital, Stockholm, Sweden.
Lancet. 2023 Mar 11;401(10379):858-873. doi: 10.1016/S0140-6736(22)02125-0. Epub 2023 Jan 19.
Asthma is one of the most common chronic non-communicable diseases worldwide and is characterised by variable airflow obstruction, causing dyspnoea and wheezing. Highly effective therapies are available; asthma morbidity and mortality have vastly improved in the past 15 years, and most patients can attain good asthma control. However, undertreatment is still common, and improving patient and health-care provider understanding of when and how to adjust treatment is crucial. Asthma management consists of a cycle of assessment of asthma control and risk factors and adjustment of medications accordingly. With the introduction of biological therapies, management of severe asthma has entered the precision medicine era-a shift that is driving clinical ambitions towards disease remission. Patients with severe asthma often have co-existing conditions contributing to their symptoms, mandating a multidimensional management approach. In this Seminar, we provide a clinically focused overview of asthma; epidemiology, pathophysiology, diagnosis, and management in children and adults.
哮喘是全球最常见的慢性非传染性疾病之一,其特征为气流受限多变,可导致呼吸困难和喘息。目前已有高效的治疗方法;在过去15年里,哮喘的发病率和死亡率已大幅改善,大多数患者能够实现良好的哮喘控制。然而,治疗不足的情况仍然普遍,提高患者和医护人员对何时以及如何调整治疗的认识至关重要。哮喘管理包括对哮喘控制情况和风险因素进行评估,并据此调整药物的循环过程。随着生物疗法的引入,重度哮喘的管理已进入精准医学时代——这一转变推动了实现疾病缓解的临床目标。重度哮喘患者通常并存一些导致其症状的疾病,这就需要采取多维度的管理方法。在本研讨会上,我们将针对哮喘,提供一份聚焦临床的概述,内容包括儿童和成人哮喘的流行病学、病理生理学、诊断及管理。
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