哮喘控制与小气道功能障碍的相关性

Correlation between asthma control and small airway dysfunction

哮喘最初被认为是主要涉及大气道的慢性炎症性疾病。病理学家和生理学家明确认识到哮喘患者炎症过程已经延伸到中央气道以外的小气道和肺实质,认为小气道是哮喘患者气流阻塞的主要部位。已经利用非侵入性技术来评估和推断哮喘小气道疾病的程度,并且可以用于评估治疗反应。随着吸入器技术的改进,使药物向整个支气管树输送从而改善哮喘的控制和自然史。该文主要就小气道功能障碍与哮喘临床表现和疾病进展相关性做一综述,目的是更好地认识小气道功能障碍作为哮喘独特的病理过程,发现更多特异性和靶向治疗,为哮喘控制提供新思路。

Asthma has been considered a chronic inflammatory disease mainly involving the large airways. Pathologists and physiologists clearly recognize that the inflammatory process of asthma patients has extended to the small airways and lung parenehyma outside the central airways and believed that the small airway is the main site of airflow obstruction in asthma patients. Non-invasive techniques have been used to assess and infer the extent of small airway disease in asthma and can be used to evaluate the treatment response. As inhaler technology improves, drugs are delivered to the entire bronchial tree to improve asthma control and natural history. This article focuses on the correlation between small airway dysfunction and asthma clinical manifestations and disease progression. The purpose is to better understand small airway dysfunction as a unique pathological process of asthma and to discover more specific and targeted therapies for asthma and provides new ideas for asthma control.