Heraganahally Subash S, Howarth Timothy, Chen Winnie
FRACP, Director, Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, NT; Professor, School of Medicine, Charles Darwin University, Darwin, NT; Associate Professor, College of Medicine and Public Health, Flinders University, Darwin, NT; Respiratory Physician, Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, NT.
PhD, Postdoctoral Researcher, Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, NT; Postdoctoral Researcher, Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Aust J Gen Pract. 2024 Dec-Supplement;53(12 Suppl):S3-S9. doi: 10.31128/AJGP-02-24-7136.
Chronic respiratory disorders in the adult Aboriginal and Torres Strait Islander population are common, but there is a sparsity of literature detailing an approach to clinical management.
This paper describes a clinical approach to chronic respiratory disorders for clinicians working with Aboriginal and Torres Strait Islander people, particularly in the remote Australian context.
There are significant differences in the way chronic respiratory diseases manifest in Aboriginal and Torres Strait Islander people compared with non-Indigenous Australians. Chronic obstructive pulmonary disease (COPD), bronchiectasis and asthma often overlap in clinical features, and can be present concurrently. Restrictive impairment on spirometry is common. The presence of bronchodilator response might indicate asthma, but can also be observed in patients with asthma/COPD/bronchiectasis overlap. Because the management of each of these conditions differs, accurate diagnosis and disease severity classification are important, particularly in the prescribing of guideline-recommended inhaled pharmacotherapy.
澳大利亚原住民和托雷斯海峡岛民成人慢性呼吸系统疾病很常见，但详细阐述临床管理方法的文献稀少。
本文描述了一种针对为澳大利亚原住民和托雷斯海峡岛民服务的临床医生，尤其是在澳大利亚偏远地区的临床医生，处理慢性呼吸系统疾病的临床方法。
与非澳大利亚原住民相比，慢性呼吸系统疾病在澳大利亚原住民和托雷斯海峡岛民中的表现方式存在显著差异。慢性阻塞性肺疾病（COPD）、支气管扩张症和哮喘在临床特征上常常重叠，且可能同时存在。肺功能测定显示限制性损害很常见。支气管扩张剂反应的存在可能提示哮喘，但在哮喘/COPD/支气管扩张症重叠的患者中也可观察到。由于这些疾病各自的管理方法不同，准确诊断和疾病严重程度分类很重要，尤其是在开具指南推荐的吸入药物治疗时。
