Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma
Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma
复制标题
DOI：
10.1016/j.jaci.2010.07.019
复制
发表时间：
2010-11-01
影响因子：
14.2
通讯作者：
Zuberbier, Torsten
中科院分区：
文献类型：
--
作者：
Bousquet, Jean;Mantzouranis, Eva;Zuberbier, Torsten
哮喘是一个全球性的健康问题，影响着所有年龄、种族和国家的约3亿人。据估计，每年约有25万人因哮喘而过早死亡。哮喘严重程度和控制的概念在评估患者及其对治疗的反应以及公共卫生、登记和研究（临床试验、流行病学、遗传学和机制研究）中很重要，但所用术语未标准化，术语经常互换使用。一个共同的国际方法是倾向于定义严重哮喘，不受控制的哮喘，当2重合，虽然适应可能需要根据当地条件。2009年4月5日至6日，世界卫生组织召开会议，提出了严重哮喘的统一定义。一篇文章由一组专家撰写，并由全球防治慢性呼吸道疾病联盟审查小组审查。重度哮喘根据当前临床控制水平和风险定义为“不受控制的哮喘，可能导致频繁重度急性发作（或死亡）和/或药物不良反应和/或慢性发病（包括儿童肺功能受损或肺生长减少）的风险。“严重哮喘包括3组，每组都有不同的公共卫生信息和挑战：（1）未经治疗的严重哮喘，（2）难以治疗的严重哮喘，（3）难治性严重哮喘。最后一组包括尽管使用最高水平的推荐治疗仍无法控制的哮喘和仅使用最高水平的推荐治疗才能维持控制的哮喘。（J Allergy Clin Immunol 2010; 126：926-38.）
Asthma is a global health problem affecting around 300 million individuals of all ages, ethnic groups and countries. It is estimated that around 250,000 people die prematurely each year as a result of asthma. Concepts of asthma severity and control are important in evaluating patients and their response to treatment, as well as for public health, registries, and research (clinical trials, epidemiologic, genetic, and mechanistic studies), but the terminology applied is not standardized, and terms are often used interchangeably. A common international approach is favored to define severe asthma, uncontrolled asthma, and when the 2 coincide, although adaptation may be required in accordance with local conditions. A World Health Organization meeting was convened April 5-6, 2009, to propose a uniform definition of severe asthma. An article was written by a group of experts and reviewed by the Global Alliance against Chronic Respiratory Diseases review group. Severe asthma is defined by the level of current clinical control and risks as "Uncontrolled asthma which can result in risk of frequent severe exacerbations (or death) and/or adverse reactions to medications and/or chronic morbidity (including impaired lung function or reduced lung growth in children)." Severe asthma includes 3 groups, each carrying different public health messages and challenges: (1) untreated severe asthma, (2) difficult-to-treat severe asthma, and (3) treatment-resistant severe asthma. The last group includes asthma for which control is not achieved despite the highest level of recommended treatment and asthma for which control can be maintained only with the highest level of recommended treatment. (J Allergy Clin Immunol 2010; 126: 926-38.)