支气管哮四喘诊治进展.pptVIP

哮喘的诊断 支气管哮喘的分期 急性发作期 慢性持续期 临床缓解期 哮喘的诊断 哮喘的分级 病情严重程度分级 控制水平的分级 急性发作期严重程度分级 哮喘的诊断 分期与分级是哮喘诊断的重要内容 完整的诊断应包括： 1. 疾病的诊断：如支气管哮喘 2. 分期：如急性发作期（重度） 3. 分级：如未控制 * 2 Asthma diagnosis depends both on the results of lung function tests and symptom assessment. Neither symptoms nor lung function tests alone are sufficient to form a diagnosis. * Figure 2-5. Levels of Asthma Control Characteristic：Controlled Partly controlled(Any measure present in any week) Uncontrolled Daytime symptoms：None (or minimal) Twice or more/week Three or more present in any week Limitations oactivities：None Any Three or more present in any week Nocturnal symptoms/awakening：None Any Three or more present in any week Need for rescue/”reliever” treatment：None (or minimal) Twice or more/week Three or more present in any week Lung function (PEF or FEV1)：Normal or near-normal 80% predicted or personal best (if known) Three or more present in any week Exacerbations：Minimal One or more/year One in any week * In treatment-na?ve patients with persistent asthma, treatment should be start at Step 2, or, if very symptomatic (uncontrolled), at step 3. All patients with persistent asthma require one or more regular controller medications (Steps 2 through 5). Step 2 is the initial treatment for most treatment-na?ve patients with persistent asthma symptoms. If symptoms at the initial consultation suggest that asthma is poorly controlled, initial treatment may be commenced at step 3. The scheme presented in Figure is based upon these principles, but the range and sequence of medications used in each clinical setting will vary depending on local availability (for cost or other reasons), acceptability and preference. * The Gaining Optimal Asthma controL (GOAL) study grew out of the analysis of the first clinical data available with Seretide, which formed part of the registration package. The Steering Committee of internationally recognise