Jayasooriya Shamanthi M, Devereux Graham, Soriano Joan B, Singh Nishtha, Masekela Refiloe, Mortimer Kevin, Burney Peter
School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
Liverpool School of Tropical Medicine, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Lancet Respir Med. 2025 Aug;13(8):725-738. doi: 10.1016/S2213-2600(24)00383-7. Epub 2025 Jul 17.
Asthma is characterised by variable airflow obstruction and is associated with symptoms of cough, wheeze, and dyspnoea, and with airway inflammation and hyperresponsiveness. There are approximately 300 million people with asthma worldwide. Despite a current plateau, the burden of this disease is likely to increase due to population growth, urbanisation, and ageing. Disease onset is associated with low birthweight, preterm birth, viral infections, in-utero passive smoke exposure, urbanisation, and occupational exposures. Obesity is associated with increased incidence and severity of asthma, whereas exposure to small allergen particles leads to severe disease. In adults and adolescents, inhaled corticosteroids in combination with formoterol (as anti-inflammatory reliever or as maintenance and anti-inflammatory reliever therapy) are widely recommended to control the symptoms of asthma. For children, low-dose inhaled corticosteroid is the preferred first-line treatment. Monotherapy with short-acting β-agonists is strongly discouraged. The WHO Global Action Plan for the Prevention and Control of Non-communicable Diseases includes availability of affordable combination inhalers for asthma. Co-ordinated national asthma policies, ensuring access to inhalers, have resulted in fewer hospitalisations and school and work absences. Future asthma prevalence could be reduced by good maternal and infant care, with reduction in premature births and reduction in infant respiratory infections, and by reduction in obesity at all ages.
哮喘的特征是气流阻塞多变，并伴有咳嗽、喘息和呼吸困难症状，以及气道炎症和高反应性。全球约有3亿哮喘患者。尽管目前处于平稳期，但由于人口增长、城市化和老龄化，这种疾病的负担可能会增加。疾病发作与低出生体重、早产、病毒感染、子宫内被动吸烟、城市化和职业暴露有关。肥胖与哮喘发病率和严重程度增加有关，而接触小的过敏原颗粒会导致严重疾病。在成人和青少年中，广泛推荐吸入皮质类固醇与福莫特罗联合使用（作为抗炎缓解剂或作为维持和抗炎缓解剂疗法）来控制哮喘症状。对于儿童，低剂量吸入皮质类固醇是首选的一线治疗方法。强烈不鼓励使用短效β受体激动剂单药治疗。世界卫生组织《预防和控制非传染性疾病全球行动计划》包括提供价格合理的哮喘联合吸入器。协调一致的国家哮喘政策，确保获得吸入器，已减少了住院人数以及学校缺课和工作缺勤情况。通过良好的母婴护理，减少早产和婴儿呼吸道感染，并降低各年龄段的肥胖率，未来哮喘患病率可能会降低。
