严重喘治疗:需要对患者进行表征
Liam G Heaney1, Douglas S Robinson
1Regional Respiratory Centre, Belfast City Hospital, Belfast, UK. l.heaney@qub.ac.uk
许多患有喘的成年人仍然表现出症状,尽管接受了治疗. 在启动新疗法 (如抗IgE治疗难以控制的喘) 之前,评估患者的潜在原因至关重要.
科学领域:
- 肺部医学 肺部医学
- 过敏和免疫学 过敏和免疫学
背景情况:
- 喘诊断通常是直接的,并对标准治疗做出反应.
- 然而,高达40%的患有喘的成年人经历了持续的症状,5%的人患有难以控制的喘.
- 新的疗法如抗免疫球蛋白E (抗IgE) 疗法正在出现,用于严重的过敏性喘.
研究的目的:
- 审查难以控制的喘的管理.
- 强调准确诊断和新疗法之前患者评估的重要性.
- 探索难以控制的喘中的潜在子组.
主要方法:
- 关于喘管理和抗IgE疗法的现有文献的审查.
- 讨论当前严重喘的定义和治疗方法.
- 强调系统的患者评估.
主要成果:
- 奥马利祖马布 (抗IgE疗法) 在减少严重过敏喘的恶化和改善症状方面表现有前途.
- 接受抗IgE治疗的患者已经证明,他们对吸入性皮质类固醇的需求减少了.
- 与安慰剂控制的研究表明,在一些患者中,可能会出现类固醇戒断.
结论:
- 严重喘的定义 (尽管有高剂量吸入类固醇的症状) 可能包括不同的患者群体.
- 系统性评估对于识别持续症状的非喘原因和避免不必要的治疗是必不可少的.
- 患者的子组可能有不同的炎症过程,影响治疗反应.
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