重症哮喘支气管热成形术适应证选择探讨

Bronchial thermoplasty in severe asthma:indication selection

支气管哮喘是一种慢性的气道炎症性疾病。目前重症哮喘的定义是当哮喘诊断明确且合并症得到良好处理,仍然需要高剂量吸入激素(ICS)联合第二种控制药物[和(或)全身糖皮质激素]治疗才能维持控制或仍未达到控制的患者。支气管热成形术(BT)是重症哮喘患者一种新的治疗选择。BT是一种新型的治疗重症哮喘的非药物疗法,它使射频热能作用于平滑肌细胞,以减少气道平滑肌的质量。BT治疗后可以改善哮喘患者的生活质量并减少急性发作,具有较长期的安全性并能持续降低哮喘的急性发作率,减少医疗费用,改善生活质量。

When a diagnosis of asthma is confirmed and comorbidities have been addressed, severe asthma is defined as ＂asthma which requires treatment with high dose inhaled corticosteroids （ICS） plus a second controller （and/or systemic corticosteroids） to prevent it from becoming ＇uncontrolled＇ or which remains ＇uncontrolled＇ despite this therapy;＇ Bronchial thermoplasty （BT） is a novel therapy for patients with severe asthma. Using radiofrequency thermal energy3 it aims to reduce the airway smooth muscle mass. It can improve quality of life and reduce the number of exacerbations. In addition, recent data has demonstrated the long-term safety of the procedure as well as sustained improvements in rates of asthma exacerbations, reduction in medical expenses, and improvement in quality of life.