Gordon B R
Division of Otolaryngology-Head and Neck Surgery, Cape Cod Hospital, Hyannis, MA, USA.
Ear Nose Throat J. 1996 Feb;75(2):97-101.
Asthma is a chronic inflammatory disease of the lower respiratory tract which is triggered by exposure to allergens or other airway irritants. This inflammation results in airway hyperresponsiveness, bronchial muscle spasm, mucous gland hypersecretion and mucosal edema, which combine to create symptoms such as cough, wheezing and respiratory distress. Because the inflammatory process is highly variable, asthma is a disorder with many possible presentations. It may therefore proceed for years without clinical recognition, and may challenge the most astute diagnostician. It is important for otolaryngologists to be able to suspect, diagnose and treat asthma. This is so because asthma is a common disease in the otolaryngologic patient population, both as one of the options in the differential diagnosis of respiratory complaints, and as a comorbid condition which may complicate the treatment of other medical or surgical problems. Furthermore, both the understanding of asthma's pathophysiology, and its optimum treatment methods have undergone radical changes during the past decade. This three-part discussion reviews our modern understanding of asthma, and proposes diagnosis and treatment guidelines which can assist otolaryngologists in effectively managing their asthmatic patients. Part one summarizes current information on the pathophysiology and increasing prevalence of asthma, its clinical variability, the assessment of asthma sensitivity, and methods for diagnosis of asthma. Parts two and three cover the strategy for asthma management, and the use of both adjunctive and anti-inflammatory therapies for asthma control.
哮喘是下呼吸道的一种慢性炎症性疾病，由接触过敏原或其他气道刺激物引发。这种炎症会导致气道高反应性、支气管肌肉痉挛、黏液腺分泌亢进和黏膜水肿，这些因素共同导致咳嗽、喘息和呼吸窘迫等症状。由于炎症过程高度可变，哮喘是一种有多种可能表现形式的疾病。因此，它可能在数年里都未被临床识别，甚至可能难倒最敏锐的诊断医生。对于耳鼻喉科医生来说，能够怀疑、诊断和治疗哮喘很重要。这是因为哮喘在耳鼻喉科患者群体中是一种常见疾病，既是呼吸疾病鉴别诊断的选项之一，也是一种可能使其他内科或外科问题治疗复杂化的合并症。此外，在过去十年里，对哮喘病理生理学的理解及其最佳治疗方法都发生了根本性变化。这个分为三个部分的讨论回顾了我们对哮喘的现代理解，并提出了诊断和治疗指南，以帮助耳鼻喉科医生有效管理他们的哮喘患者。第一部分总结了关于哮喘病理生理学、发病率上升、临床变异性、哮喘敏感性评估以及哮喘诊断方法的当前信息。第二部分和第三部分涵盖哮喘管理策略，以及使用辅助治疗和抗炎治疗来控制哮喘。
