- 期刊
嗜伊紅性與非嗜伊紅性白血球氣喘在致病機轉與治療上的差異
Differences in the Pathophysiology and Treatment between Eosinophilic and Non-Eosiophilic Asthma
摘要
氣喘是一種慢性氣道炎症疾病，通常會有呼吸困難、咳嗽、胸悶及喘鳴聲等表現。近年來經由非侵入性的痰液誘導技術(induced sputum techniques)，分析痰液發炎細胞的類型，發現氣喘的炎症反應是一種異質性的變化，臨床上嗜中性球為主的氣喘病人，通常年紀較大，有抽菸病史，過敏成份較低，經常呈現固定性氣道阻塞(fixed airway obstruction)；相對的，嗜伊紅性血球為主的氣喘病人，通常年紀較輕，有較嚴重的氣道過度反應(airwayhyperresponsiveness)。另外，難治性氣喘的呼吸道炎症病變，常以非嗜伊紅性白血球(特別是嗜中性白血球)為主。不同的細胞分型，對於類固醇治療的療效，似有不同的影響，因此評估氣喘的異質性對於治療策略的選擇，十分重要。
並列摘要
Asthma is a chronic airway inflammation disease. Patients present variable symptoms such as cough, chest tightness, shortness of breathing or wheezing. In recent studies by induced sputum techniques, we find that the airway inflammation of asthma is heterogeneous. According to different cell types in induced sputum, such as eosinophil or neutrophil prominent, there is different response of inhaled corticosteroid in different phenotype of asthma patients. Furthermore, it seems that older, smoking history, fixed airway obstruction or non-allergic asthma patients have non-eosinophil profile of sputum. On the contrary, allergic asthma patients usually have dominant eosinophil in induced sputum. In conclusion, different phenotypes of asthma should have different choices of treatment. We need to arrange tailored plans for each asthma patient.