Asthma management in sickle cell disease.
Asthma management in sickle cell disease.
复制标题
镰状细胞病的哮喘治疗。
DOI：
10.1155/2013/604140
复制
发表时间：
2013
影响因子：
--
通讯作者：
Morris,ClaudiaR
中科院分区：
文献类型：
--
作者：
Gomez,Esteban;Morris,ClaudiaR
哮喘是镰状细胞病（SCD）的常见共病因素。然而，与一般人群相比，SCD中哮喘的发病率远高于预期。SCD中的“哮喘”是否纯粹与遗传和环境因素有关，或者更确切地说是潜在的溶血和炎症状态的结果，是最近争论的话题。无论病因如何，由支气管收缩和与哮喘急性发作相关的炎症引起的低氧血症将导致镰状化和随后的SCD并发症的循环。最近的研究证实，哮喘易导致SCD的并发症，如疼痛危象、急性胸部综合征和中风，并与死亡率增加有关。哮喘的早期识别和积极的护理管理标准可以预防严重的肺部并发症并降低死亡率。然而，关于SCD中哮喘管理的数据非常有限。需要临床试验来评估目前的哮喘治疗对SCD和并发哮喘患者的有效性，同时需要机制研究来描述潜在的病理生理学。
Asthma is a common comorbid factor in sickle cell disease (SCD). However, the incidence of asthma in SCD is much higher than expected compared to rates in the general population. Whether “asthma” in SCD is purely related to genetic and environmental factors or rather is the consequence of the underlying hemolytic and inflammatory state is a topic of recent debate. Regardless of the etiology, hypoxemia induced by bronchoconstriction and inflammation associated with asthma exacerbations will contribute to a cycle of sickling and subsequent complications of SCD. Recent studies confirm that asthma predisposes to complications of SCD such as pain crises, acute chest syndrome, and stroke and is associated with increased mortality. Early recognition and aggressive standard of care management of asthma may prevent serious pulmonary complications and reduce mortality. However, data regarding the management of asthma in SCD is very limited. Clinical trials are needed to evaluate the effectiveness of current asthma therapy in patients with SCD and coincident asthma, while mechanistic studies are needed to delineate the underlying pathophysiology.