The diagnosis of asthma. Can physiological tests of small airways function help?
The diagnosis of asthma. Can physiological tests of small airways function help?
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DOI：
10.1177/14799731211053332
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发表时间：
2021-01
影响因子：
4.1
通讯作者：
Sapey E
中科院分区：
文献类型：
--
作者：
Almeshari MA;Stockley J;Sapey E
哮喘是一种常见的慢性异质性疾病，具有全球性影响和巨大的经济成本。它还与显著的死亡率和发病率相关，并且未诊断的哮喘的负担是显著的。哮喘可能很难诊断，因为没有金标准测试，虽然肺量测定是诊断哮喘的核心，但它可能不足以确认或排除诊断。最常报告的肺量测定（一秒用力呼气量（FEV1）和用力肺活量）评估较大气道的功能。然而，小气道功能障碍在哮喘中非常普遍，一些研究表明小气道受累是最早的疾病表现之一。此外，还有专门针对小气道设计的超细颗粒吸入疗法。潜在地，小气道的测试可能比肺量测定法更准确地诊断早期或轻度哮喘并评估对治疗的反应。此外，有些评估技术并不依赖于强制性的应急机动，因此对某些群体来说可能更容易进行。本综述讨论了小气道试验在哮喘中的现有证据，以及进一步评估其效用所需的未来研究。
Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, while spirometry is central in diagnosing asthma, it may not be sufficient to confirm or exclude the diagnosis. The most commonly reported spirometric measures (forced expiratory volume in one second (FEV1) and forced vital capacity assess function in the larger airways. However, small airway dysfunction is highly prevalent in asthma and some studies suggest small airway involvement is one of the earliest disease manifestations. Moreover, there are new inhaled therapies with ultrafine particles that are specifically designed to target the small airways. Potentially, tests of small airways may more accurately diagnose early or mild asthma and assess the response to treatment than spirometry. Furthermore, some assessment techniques do not rely on forced ventilatory manoeuvres and may, therefore, be easier for certain groups to perform. This review discusses the current evidence of small airways tests in asthma and future research that may be needed to further assess their utility.
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影响因子：
4.1
作者：
Almeshari MA;Alobaidi NY;Edgar RG;Stockley J;Sapey E
通讯作者：
Sapey E
影响因子：
--
作者：
Cottini, Marcello;Lombardi, Carlo;Micheletto, Claudio
通讯作者：
Micheletto, Claudio
影响因子：
9.6
作者：
Bickel, Scott;Popler, Jonathan;Eid, Nemr
通讯作者：
Eid, Nemr
影响因子：
2.6
作者：
Duffey, Hannah;Anderson, William C., III
通讯作者：
Anderson, William C., III
DOI：
10.1183/20734735.020514
发表时间：
2015-03
期刊：
Breathe (Sheffield, England)
影响因子：
--
作者：
Brashier B;Salvi S
通讯作者：
Salvi S