[Difficult to control severe asthma].

Q4 Medicine Revue Du Praticien Pub Date : 2011-03-01
Antoine Magnan, Anaïs Pipet
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Abstract

Difficult to control severe asthma is characterized by the persistence of inacceptable symptoms of asthma despite a continuous treatment with at least high doses of inhaled steroids and long acting bronchodilators. The diagnosis is done after a period of observation and some investigations that will allow confirm the diagnosis of asthma, eliminate alternative diagnosis and etiological forms that would be difficult to treat intrinsically (allergic broncho-pulmonary aspergillosis, Churg and Strauss disease, chronic eosinophilic pneumonia, occupational asthma). At the end of this period devoted to diagnosis a systematic approach is set up to take care of these patients. Therapeutic education includes action plans and measures for triggering factors avoidance in order to prevent exacerbations. Comorbidities such as rhinitis, nasal polyposis, gastro-oesophageal reflux and obesity are taken into account. Lastly, the treatment must be adapted according to the patient's preferences and aims, and to the asthma severity. Ultimately in steroid-dependent asthma, the lowest efficient dose is tracked continuously. For these patients, new molecules are needed.

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[严重哮喘难以控制]。
难以控制的严重哮喘的特点是,尽管持续使用至少高剂量的吸入类固醇和长效支气管扩张剂进行治疗,但仍存在不可接受的哮喘症状。诊断是经过一段时间的观察和一些调查后作出的,这些调查将有助于确认哮喘的诊断,消除难以本质治疗的其他诊断和病因形式(过敏性支气管-肺曲霉病、Churg和Strauss病、慢性嗜酸性粒细胞性肺炎、职业性哮喘)。在这个致力于诊断的时期结束时,建立了一个系统的方法来照顾这些病人。治疗性教育包括避免触发因素的行动计划和措施,以防止病情恶化。合并症,如鼻炎,鼻息肉病,胃食管反流和肥胖被考虑在内。最后,治疗必须根据患者的喜好和目标以及哮喘的严重程度进行调整。最终,在类固醇依赖性哮喘中,最低有效剂量被持续跟踪。对于这些患者,需要新的分子。
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来源期刊
Revue Du Praticien
Revue Du Praticien Medicine-Medicine (all)
CiteScore
0.20
自引率
0.00%
发文量
161
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