选择性国际儿科哮喘指南概览》的启示。

IF 1.3 Q3 PEDIATRICS Current Pediatric Reviews Pub Date : 2024-01-29 DOI:10.2174/0115733963270829231221062201
Kam Lun Ellis Hon, Daniel K K Ng, Wa Keung Chiu, Alexander K C Leung
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引用次数: 0

摘要

背景:哮喘是一种慢性特应性和炎症性支气管疾病,其特点是症状反复出现、发作性可逆支气管阻塞和易诱发支气管痉挛。哮喘通常始于儿童时期。国际指南已被广泛接受和实施,但在管理方法上却有异曲同工之妙。亚洲的许多城市都没有全国性的指南。本综述旨在从实用的角度介绍当前儿童哮喘管理的建议,特别是以下几个方面:诊断、严重程度分类、治疗方案和哮喘控制,并为医生提供哮喘管理的最新信息:我们使用 PubMed 的临床查询功能,以 "哮喘"、"儿科 "和 "指南 "为关键词进行搜索。筛选条件包括 "临床预测指南"、"病因学"、"诊断"、"治疗"、"预后 "和 "狭窄 "范围。搜索于 2022 年 11 月进行。从该搜索中检索到的信息被用于撰写本文:临床诊断基于症状模式、对支气管扩张剂和吸入皮质类固醇治疗的反应以及肺功能测试(PFT)。哮喘根据症状频率、呼气峰流速(PEFR)、一秒钟用力呼气容积(FEV1)、特应性病因与非特应性病因进行分类,其中特应性病因是指易发生 1 型超敏反应。哮喘还分为间歇性和持续性(轻度到重度)。遗憾的是,哮喘目前还没有根治的方法。不过,可以通过避免诱发因素来预防症状,并通过吸入皮质类固醇来抑制症状。如果哮喘症状未得到控制,抗白三烯药物或长效β-激动剂(LABA)可与吸入皮质类固醇一起使用。症状迅速恶化时,通常使用吸入式短效β2受体激动剂(SABA,如沙丁胺醇)和口服皮质类固醇。哮喘发作严重时需要静脉注射皮质类固醇和住院治疗。一些指南还对生物制剂和免疫疗法的使用提出了建议:结论:哮喘由临床诊断,并辅以实验室检测。治疗以严重程度分类为基础,从间歇性到持续性。吸入支气管扩张剂和类固醇抗炎药物是主要的治疗方法。
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Insights from Overviewing Selective International Guidelines for Pediatric Asthma.

Background: Asthma is a chronic atopic and inflammatory bronchial disease characterized by recurring symptoms and, episodic reversible bronchial obstruction and easily triggered bronchospasms. Asthma often begins in childhood. International guidelines are widely accepted and implemented; however, there are similarities and differences in the management approaches. There is no national guideline in many cities in Asia. This review aims to provide a practical perspective on current recommendations in the management of childhood asthma, specifically in the following aspects: diagnosis, classification of severity, treatment options, and asthma control, and to provide physicians with up-to-date information for the management of asthma.

Methods: We used the PubMed function of Clinical Queries and searched keywords of "Asthma", "Pediatric," AND "Guidelines" as the search engine. "Clinical Prediction Guides", "Etiology", "Diagnosis", "Therapy," "Prognosis," and "Narrow" scope were used as filters. The search was conducted in November 2022. The information retrieved from this search was used in compiling the present article.

Results: Diagnosis is clinically based on symptom pattern, response to therapy with bronchodilators and inhaled corticosteroids, and spirometric pulmonary function testing (PFT). Asthma is classified in accordance with symptom frequency, peak expiratory flow rate (PEFR), forced expiratory volume in one second (FEV1), atopic versus nonatopic etiology, where atopy means a predisposition toward a type 1 hypersensitivity reaction. Asthma is also classified as intermittent or persistent (mild to severe). Unfortunately, there is no disease cure for asthma. However, symptoms can be prevented by trigger avoidance and suppressed with inhaled corticosteroids. Antileukotriene agents or long-acting beta-agonists (LABA) may be used together with inhaled corticosteroids if symptoms of asthma are not controlled. Rapidly worsening symptoms are usually treated with an inhaled short-acting beta-2 agonist (SABA, e.g., salbutamol) and oral corticosteroids. Intravenous corticosteroids and hospitalization are required in severe cases of asthma attacks. Some guidelines also provide recommendations on the use of biologics and immunotherapy.

Conclusion: Asthma is diagnosed clinically, with supporting laboratory testing. Treatment is based on severity classification, from intermittent to persistent. Inhaled bronchodilator and steroid anti-inflammatory form the main stay of management.

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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
66
期刊介绍: Current Pediatric Reviews publishes frontier reviews on all the latest advances in pediatric medicine. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in pediatric medicine.
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