老年支气管哮喘诊治的现状和挑战

Current status and challenges of elderly bronchial asthma

随着全球人口老龄化,老年支气管哮喘(哮喘)患者人数逐年升高。因呼吸系统结构功能随年龄变化,并伴随着免疫衰老、炎症衰老、感知及认知能力下降、药代动力学和药效学等多方面变化,导致老年哮喘误诊率和漏诊率高。此外,由于老年哮喘合并症及并发症多,在治疗、管理上也存在诸多特殊性。因此,需要重视对老年哮喘的诊断与鉴别诊断,从生理、心理、认知、社会因素等多维度对老年哮喘进行综合评估,构建多学科团队对老年哮喘进行个体化管理。

With global aging,the number of elderly bronchial asthma(asthma)patients has been increasing year by year.With the structural and functional changes in the respiratory system accompanying aging,coupled with various changes such as immunosenescence,inflammaging,decreased perception and cognitive abilities,as well as alterations in pharmacokinetics and pharmacodynamics,the misdiagnosis and underdiagnosis rates of elderly asthma are relatively high.Furthermore,due to the multiple comorbidities and complications in elderly asthma patients,there also exitst many specific considerations in the treatment and management.Therefore,it is essential to pay attention to the diagnosis and differential diagnosis of elderly asthma,to assess comprehensively of elderly asthma from multiple dimensions such as physiology,psychology,cognition,and social factors,and to establish a multidisciplinary team for personalized management of elderly asthma.