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大人 の 喘息 の 診断 と 治療: レビュー
Jennifer L McCracken1, Sreenivas P Veeranki2, Bill T Ameredes3
1Division of Allergy and Clinical Immunology, University of Texas Medical Branch, Galveston.
JAMA
|July 19, 2017
まとめ
成人 の 患者 の 状態 を 改善 する に は,効果 的 な 喘息 の 診断,モニタリング,治療 が 極めて 重要 です
科学分野:
- 肺科
- アレルギーと免疫学
- 臨床医学
背景:
- 喘息は成人の7.5%に影響し,喘息,呼吸不全,咳などの異質呼吸器症候群として表れます.
- 診断には症状の評価とスピロメトリーが含まれており,可逆的な呼吸道阻害を確認します.
- アレルゲンへの感受性を特定することは,個別化された喘息管理に臨床的に重要である.
研究 の 目的:
- 大人の喘息の現在の証拠に基づいた診断,モニタリング,治療戦略を要約します.
- 患者の治療結果を改善するために 個別化された治療の重要性を強調する.
- 標準的な治療から先進的な生物学的治療への選択肢の概要です.
主な方法:
- 喘息の管理に関する最新の医学文献と臨床ガイドラインのレビュー
- スピロメトリーとアレルゲン感受性検査を含む診断基準の分析
- 呼吸用コルチコステロイド,長時間作用する支氣管拡張剤,生物学的薬剤を含む治療介入の評価
主要な成果:
- 慢性的な喘息の標準的な治療は,呼吸用コルチコステロイド (ICS) と短期効力ベータアゴニスト (SABA) を併用して症状を緩和します.
- 併用療法 (ICS + 長効ベータアゴニスト) は,ICS単独では不十分である場合に有効です.
- 長時間作用するベータアゴニスト (LABA) 単独では推奨されません.他のコントロール剤には,ティオトロピウムやオマリズマブ,メポリズマブ,レスリズマブなどの生物学的薬が含まれます.
結論:
- 喘息の治療には 呼吸道阻害や過敏性 炎症の治療が必要です
- 一貫した日々のコントロール薬,環境要因の回避,迅速な症状の緩和が鍵です.
- 重度の喘息は専門医の診察と 生物学的薬を含む先進的な治療法による治療が 有益である.
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