Rối loạn chức năng đường thở nhỏ và kiểm soát hen suyễn kém: một mối quan hệ nguy hiểm

Clinical and Molecular Allergy - Tập 19 - Trang 1-10 - 2021
Marcello Cottini1, Anita Licini1, Carlo Lombardi2, Diego Bagnasco3, Pasquale Comberiati4, Alvise Berti5,6
1Allergy and Pneumology Outpatient Clinic, Bergamo, Italy
2Departmental Unit of Allergology, Immunology and Pulmonary Diseases, Fondazione Poliambulanza, Brescia, Italy
3Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genova, Italy
4Section of Pediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
5Ospedale Santa Chiara and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
6Thoracic Disease Research Unit, Mayo Clinic, Rochester, USA

Tóm tắt

Hen suyễn là một bệnh lý mãn tính phổ biến, ảnh hưởng đến khoảng 339 triệu người trên toàn thế giới. Mục tiêu chính của các hướng dẫn điều trị hen suyễn hiện nay là đạt được kiểm soát lâm sàng, bao gồm cả triệu chứng và hạn chế của bệnh nhân cũng như nguy cơ tương lai gặp phải các kết quả bất lợi liên quan đến hen suyễn. Mặc dù các thử nghiệm lâm sàng ngẫu nhiên cho thấy rằng kiểm soát hen suyễn là một mục tiêu có thể đạt được, một tỷ lệ đáng kể người bệnh hen suyễn vẫn chưa được kiểm soát tốt trong thực tế. Việc tham gia của các đường thở nhỏ ở ngoại vi gần đây đã được công nhận nhiều hơn trong hen suyễn, và nhiều nghiên cứu cho thấy rằng tình trạng viêm mạn tính ở những vị trí này dẫn đến rối loạn chức năng đường thở nhỏ (SAD), đóng góp mạnh mẽ vào việc kiểm soát hen suyễn kém. Nhìn chung, đo dao động xung lực (IOS), được giới thiệu trong những năm gần đây, dường như có khả năng đánh giá nhạy cảm các đường thở nhỏ, trong khi các phương pháp spirometry cổ điển thì không. Vì vậy, IOS có thể rất hữu ích trong việc đặc trưng hóa SAD và định hướng lựa chọn liệu pháp. Mục tiêu của bài viết này là xem xét tài liệu về SAD và ảnh hưởng của nó đối với việc kiểm soát hen suyễn, nhấn mạnh những bằng chứng mới nhất.

Từ khóa

#hen suyễn #rối loạn chức năng đường thở nhỏ #kiểm soát hen suyễn #viêm mạn tính #đo dao động xung lực #liệu pháp điều trị

Tài liệu tham khảo

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