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在指南中将振荡计添加到螺旋计中,可以更好地识别不受控制的喘,未来的恶化以及潜在的向治疗
Stanley P Galant1, Tricia Morphew2
1Children's Hospital of Orange County, Orange County, California; University of California Irvine, Irvine, California.
概括
脉冲振荡计 (IOS) 可以在喘中识别周围呼吸道损伤 (PAI),即使在控制良好的患者中也是如此. 通过IOS和向疗法早期发现PAI,可以改善喘控制和治疗结果.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床医学 临床医学
背景情况:
- 外周呼吸道损伤 (PAI) 越来越被认为是喘的重要因素.
- 目前的喘指导方针可能无法在所有患者中完全捕捉PAI,这可能导致低于最佳的管理.
- 脉冲振荡计 (IOS) 提供了一种评估外围气道的方法,补充了传统的螺旋计.
研究的目的:
- 审查最近在了解PAI检测使用IOS的临床意义方面的进展.
- 探索向治疗在管理PAI和改善喘结果中的作用.
- 评估IOS在识别失控喘和预测恶化的有用性.
主要方法:
- 在PubMed和谷歌的系统文献搜索中,寻找有关IOS和喘的研究.
- 对通过IOS识别的PAI与喘控制和恶化相关的发现进行分析.
- 针对PAI的向疗法研究的综述,包括额外精细的吸入性皮质类固醇.
主要成果:
- 在各种种族中,PAI始终与不受控制的喘有关.
- 即使在目前的指导方针中被认为得到良好控制的患者中,PAI也很普遍.
- 由IOS衍生的分数 (R5-R20,AX,X5) 预测了喘控制和恶化,在某些分析中单独优于FEV1.
- 将FEV1与PAI评估结合起来,可以更好地识别不受控制的喘和恶化.
- 外拉芬吸入的皮质类固醇比非外拉芬配方更有效地改善了周围呼吸道功能和控制喘.
结论:
- IOS是一种有价值的工具,应该考虑在未来的喘指南中与螺旋计一起纳入.
- 向治疗,特别是额外精细的吸入性皮质类固醇,在治疗PAI和改善喘控制方面表现有前途.
- 识别和治疗PAI可以导致更好的喘结果,特别是在特定的表型,如肥胖相关的喘.
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