Wheezing in children with sickle cell disease.
Wheezing in children with sickle cell disease.
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DOI：
10.1097/mop.0000000000000045
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发表时间：
2014-02
影响因子：
3.6
通讯作者：
DeBaun MR
中科院分区：
文献类型：
--
作者：
Glassberg JA;Strunk R;DeBaun MR
本文旨在全面综述镰状细胞病（SCD）的喘息，包括流行病学、病理生理学、喘息与SCD发病率之间的关系，以及评估和管理SCD患者喘息的临床方法。喘息在SCD中很常见，在一些个体中，它是SCD相关肺部疾病的固有组成部分，而不是哮喘。新出现的数据表明，无论病因如何，患有SCD和复发性喘息的个体随后发病和过早死亡的风险增加。我们认为，急性喘息和有呼吸道症状的个体应该使用β受体激动剂和口服类固醇的短期治疗，通常少于3天，以减轻反弹血管闭塞性疾病。对于那些喘息和有病史或检查与特应性，我们考虑哮喘治疗和监测每NHLBI哮喘指南。SCD的喘息应在急性情况下积极治疗，并使用控制药物。有必要进行前瞻性的SCD特异性临床试验，以确定抗炎哮喘治疗（白三烯拮抗剂、吸入皮质类固醇）是否可以安全地减轻SCD喘息的后遗症。
The purpose of this article is to provide a comprehensive review of wheezing in sickle cell disease (SCD) including epidemiology, pathophysiology, associations between wheezing and SCD morbidity and finally the clinical approach to evaluation and management of individuals with SCD who wheeze. Wheezing is common in SCD and in some individuals represents an intrinsic component of SCD related lung disease rather than asthma. Emerging data suggest that regardless of the etiology, individuals with SCD and with recurrent wheezing are at increased risk for subsequent morbidity and premature mortality. We believe Individuals that acutely wheeze and have respiratory symptoms should be managed with a beta agonist and short term treatment of oral steroids, typically less than 3 days to attenuate rebound vaso-occlusive disease. For those that wheeze and have a history or examination associated with atopy, we consider asthma treatment and monitoring per NHLBI asthma guidelines. Wheezing in SCD should be treated aggressively in both the acute setting and with controller medications. Prospective SCD-specific clinical trials will be necessary to address whether anti-inflammatory asthma therapies (leukotriene antagonists, inhaled corticosteroids) can safely mitigate the sequelae of wheezing in SCD.