Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control.
Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control.
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DOI：
10.1016/s0140-6736(08)61450-6
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发表时间：
2008-09-20
期刊：
影响因子：
168.9
通讯作者：
Suki, Bela
中科院分区：
文献类型：
--
作者：
Frey, Urs;Suki, Bela
虽然评估哮喘控制对指导治疗很重要，但由于急性发作的时间模式和风险往往是不可预测的，因此很困难。在这篇综述中，我们总结了经典的方法来评估控制与一维和多维的方法。接下来，我们将展示复杂性科学的思想如何解释支气管哮喘和肺气肿看似不可预测的性质，并对慢性阻塞性肺病产生影响。我们表明，波动分析，统计物理学中使用的方法，可以用来深入了解哮喘作为一种动态的呼吸系统疾病，被视为一组相互作用的子系统（如，炎症，免疫和机械）。波动分析方法的基础是肺功能参数的长期时间历史的量化。我们总结了这种分析如何用于评估未来哮喘发作的风险，以及对儿童和成人哮喘严重程度和控制的影响。
Although assessment of asthma control is important to guide treatment, it is difficult since the temporal pattern and risk of exacerbations are often unpredictable. In this Review, we summarise the classic methods to assess control with unidimensional and multidimensional approaches. Next, we show how ideas from the science of complexity can explain the seemingly unpredictable nature of bronchial asthma and emphysema, with implications for chronic obstructive pulmonary disease. We show that fluctuation analysis, a method used in statistical physics, can be used to gain insight into asthma as a dynamic disease of the respiratory system, viewed as a set of interacting subsystems (eg, inflammatory, immunological, and mechanical). The basis of the fluctuation analysis methods is the quantification of the long-term temporal history of lung function parameters. We summarise how this analysis can be used to assess the risk of future asthma episodes, with implications for asthma severity and control both in children and adults.