PDF(Pubmed)
Abstract：
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
摘要：
关于影响小儿哮喘的合并症健康状况的范围和影响的真实世界数据很少，特别是来自发展中国家。缺乏数据阻碍了有效的诊断，治疗,以及对这些复杂案件的全面管理。我们,特此,根据关联证据描述常见的小儿哮喘合并症，影响哮喘控制的潜在机制，和治疗效益。肥胖,上呼吸道过敏,呼吸功能失调,多重致敏,抑郁症,食物过敏,胃食管反流与难以治疗的哮喘常见关联.另一方面,哮喘症状和/或管理可能会通过药物不良反应对儿童的健康产生负面影响，过敏反应症状恶化，令人不安的心理健康。对这些疾病的认识对于为每个哮喘儿童单独设计最佳护理至关重要，并可能最终改善患者及其家人的生活质量。需要一个多学科的医生团队来识别和管理此类合并症，以减轻哮喘药物治疗的过度使用。哮喘研究应针对临床实践中遇到的相关现实问题，并着重于减轻此类合并症影响的干预措施。最后,我们敦促政策制定者和全球医疗保健组织认识到小儿哮喘控制是医疗保健的优先事项，并为研究和临床干预分配资源。换句话说,全球哮喘控制需要富有同情心的科学伙伴关系的支持.
