重视上呼吸道疾病的认识、诊疗和预防

Raising awareness of upper airway diseases: Overview of management and prevention strategies

鼻腔(包括鼻窦)是上呼吸道的重要组成部分,其黏膜表层由假复层柱状上皮组成。鼻腔具有许多重要的生理学功能,例如对吸入气体的过滤、加温、加湿等。位于鼻腔顶部的嗅区上皮还具有重要的嗅觉功能,这也是人类识别周围环境和保护人体不受外界危险物质侵袭的重要防御机能之一。鼻腔黏膜上皮作为人体与外界接触的第一道生理和免疫学屏障,能够清除空气中绝大多数的颗粒,其中不乏大量的污染物质、致病微生物(如病毒、细菌、真菌)和过敏原等,因此发生于鼻腔的鼻炎(过敏性或感染性),鼻-鼻窦炎及其相关的合并症等都是全球性常见病和高发病。在过去的10~20年间,随着医学科学技术和科研工作的深入和发展,我们对鼻部常见疾病的免疫和病理生理学机制的理解有了很大提高,为改善现有的诊疗技术和研发更有效的治疗鼻部和相关呼吸道疾病的新疗法提供了良好的机遇。随着气象、环境(污染)、易感人群等外因的变化,上呼吸道疾病在流行病学、病种等方面呈现出诸多新特征,我们在基础和临床科研工作中应重新认识该疾病,以便更有效地对该疾病进行预防、诊断和治疗。

The nose together w ith the paranasal sinuses is the main par t of the upper air way, which is lined w ith pseudostratified columnar ciliated epithelium. There are several important physiological functions such as conditioning and filtration of the inspired air and the provision of end organ for the sense of smell. Besides the nose also fulfills a physical and immunological barrier as the nasal epithelium is the first site of interaction between the host tissue and foreign invaders, such as viruses, bacteria, fungi, allergens, and harmful particulates. Hence, nasal diseases such as rhinitis（allergic and infectious） and rhinosinusitis are the most common health problems worldwide, affecting millions of people of all ages. In the past 10 to 20 years, our understanding of the immuno-pathophysiological mechanisms underlying the common nasal diseases has been significantly enhanced by in vivo and in vitro studies. This allows the development of novel therapeutic strategies designed to improve the physiological and immune defense functions of the nose, as well as for other common airway diseases. Since the dynamically external changes of atmosphere, environment（pollution） and susceptible population, we are now facing some of new features on epidemiology and the types of upper airway diseases that require us to in-deep study the diseases through basic and clinical researches, so as to further understand the prevention, diagnosis and treatment of the diseases.