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尽管对哮喘的进展有些了解,但本病在小儿中的发病率及病死率仍高。虽然涉及很多因素,但主要的因素是过量应用β兴奋药加之抗炎药使用不足引起病死率增高。对轻度哮喘亦存在气道炎症的论证及炎性刺激增加气道反应性的观察致使在疾病较早期应用抗炎药。但目前可得到的具有抗炎活性的药物不是对全部病人均有效。由小儿慢性严重哮喘(尽管适当应用皮质类固醇)提出的问题,提示我们现在的概念过于简单化。因此,卫生保健人员在对该病治疗时必须保持清醒的头脑。
Despite some knowledge of the progress of asthma, the incidence and mortality of this disease in children are still high. Although many factors are involved, the main factor is the overdose of β-stimulants in combination with the underutilization of anti-inflammatory drugs, leading to an increased mortality. The demonstration of airway inflammation in mild asthma and the observation that inflammatory stimuli increase airway responsiveness lead to the use of anti-inflammatory drugs earlier in the disease. However, currently available anti-inflammatory drugs are not effective in all patients. The problems raised by pediatric chronic severe asthma (despite the proper use of corticosteroids) suggest that our current concept is too simplistic. Therefore, health care providers must keep a clear head in their treatment of the disease.