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本文主要回顾了哮喘致病因素与大小气道有关的生理、病理和临床方法的认识,评价了目前哮喘病关于气道病变部位的现状。越来越多的病理组织学证据证实:哮喘病不仅有小气道慢性结构改变,而且有小气道症状。这种气道改变对哮喘患者的临床表现和生理功能异常有何重要作用?目前有效的抗炎治疗是否针对这些小气道?这种针对性治疗是否对临床有效?显然,由于小气道活检困难以及对这一部位缺乏特异性的检测手段,在哮喘发病中小气道病变远未受到重视。
This article mainly reviews the understanding of the pathophysiological, pathological and clinical approaches to the pathogenesis of airway disease in asthma, and evaluates the current status of asthma in the area of airway lesions. A growing body of histopathological evidence confirms that asthma has not only small changes in small airways, but also small airway symptoms. Is this airway alteration important for the clinical presentation and physiologic dysfunction in patients with asthma? Are there effective anti-inflammatory therapies targeting these small airways? Is this targeted therapy clinically effective? Obviously, because of the difficulty of small airway biopsies and The lack of specific detection of this part of the means in the pathogenesis of small airway disease is far from attention.