多数医生赞成用激素治疗急性重症哮喘,因未用激素是病死原因之一;但也有持不同看法者。为解决这一矛盾,须重新复习哮喘的发病机理及激素的作用。重症哮喘的病理生理过去20年哮喘的病理生理概念已改变,认为是由病毒、变应原及非特异性刺激加重了原有的气道慢性炎症,释放化学递质使支气管平滑肌痉挛。哮喘可突然发作,但大多数是在长期控制欠佳或病情已拖延数天甚至数周基础上发作。治疗应该口服和吸入激素,也需要全身用药。支气管舒张剂对解 Most physicians favor hormone therapy for acute severe asthma, as unused hormones are one of the causes of death; others have different opinions. In order to solve this contradiction, we must review the pathogenesis of asthma and the role of hormones. Pathophysiology of Severe Asthma The concept of pathophysiology of asthma has changed over the past two decades and is thought to be due to viral, allergen and unspecific stimuli that exacerbate the chronic airway inflammation and release chemical mediators to bronchial smooth muscle spasms. Sudden onset of asthma can occur, but most often occur on the basis of long-term poor control or the condition has been delayed for days or even weeks. Treatment should be oral and inhaled hormones, but also the need for systemic medication. Bronchodilator solution