Yıl: 2018 Cilt: 19 Sayı: 4 Sayfa Aralığı: 157 - 163 Metin Dili: Türkçe İndeks Tarihi: 20-05-2019
ZOR ASTIM
Öz: Astım havayolu inflamasyonu ile seyreden çeşitli kliniközelliklere sahip bir hastalıktır. Dünyada yaklaşık 300milyon insanı etkileyen bir inflamatuvar hastalıktır. Astımsemptomları alerjenler gibi risk faktörlerinden kaçınarakve etkili inhaler tedavi ile kontrol altına alınmaktadır.Astımlı hastaların büyük bir çoğunluğu uygun tedaviile kontrol altına alınmaktadır. Astımlı hastaların %5-10’unu oluşturan zor astım klinisyenler için tanımıve tedavisi hala zor bir grubu oluşturmaktadır. İş gücükaybı ve ekonomik maliyet açısından yüksektir. Uyguntedaviye rağmen bazı olguların kontrolü zorlaşmaktadır.Standart tedavi ile kontrol edilemeyen, steroide bağımlıveya dirençli astım olgularını içermektedir. Astıma bağlıölümlerin çoğu ağır olan veya stabil olmayan gruptagörülmektedir. Heterojen bir hastalık olan astımda farklıfenotipler vardır ve net olarak anlaşılmamıştır. Tedaviyönetimi için multidisipliner yaklaşım gerekmektedir. Ağırastım hastalığın ilk yıllarında veya yıllar sonra gelişebilir.Ağır astımda fenotipe özgü tedaviler günümüzde önemkazanmıştır ve tedavi maliyeti yüksektir. Genetik, çevreselfaktörler, yaş ve hastalık süresinin ağır astımda rolüolduğuna dair kanıtlar vardır. Özellikle genetik ve çevreselfaktörler ağır astımda önemli rol oynamaktadır. Ağır astımolduğu düşünülen hastalar dikkatle değerlendirilmelidir.Birçok hastalık astımı taklit edebilir. Bu hastalardaöncelikle astım tanısı doğrulanmalıdır. KOAH ve vokalkord disfonksiyonu ayırıcı tanıda özellikle dikkat edilmesigerekli hastalıklardır. İkinci olarak hastanın tedaviyeuyumu gözden geçirilmelidir. Ardından sigara içimi,atopik durum, çalışma ortamı ve aspirin aşırı duyarlılığıgibi faktörler araştırılmalıdır. Aynı zamanda ek hastalıklargibi astım kontrolünü etkileyebilen durumlar gözdengeçirilmelidir. Astımı zorlaştıran durumlar tek tekaraştırılmalıdır. Bu derlemede ağır astım tanımı, ayırıcıtanıların dışlanması, fenotipleri ve tedavi yaklaşımları elealınmıştır.
Anahtar Kelime: Konular:
SEVERE ASTHMA
Öz: Asthma is a common inflammatory disease that has wide clinical characteristics of the airway of the lungs. Asthma symptoms can be prevented by avoiding triggers like allergens and by the effective inhaled treatment. The majority of asthma patients can be treated effectively by current medications. Difficult asthma is a distinct entity of asthma, comprising approximately %5-10 of asthmatic patients. Despite the high effective treatment, the patients with asthma have disease that is poorly controlled. Severe asthmatics account for up to half of the cost for asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant asthma patients. Asthma related deaths are seen especially in severe asthma group. Asthma is a heterogeneous disease, consisting of different phenotypes. It requires multidisciplinary approach for treatment management. Severe asthma may suddenly develop in early time in disease or overtime. There was an evidence that severe asthma related to genetic factors, environmental factors, age, inflammation, duration of disease The genetic and environmental factors may play a role in severe asthma management. Phenotypetargeted therapy has an important role in severe asthma, but it is associated with high treatment costs. At first diagnosis of asthma must be confirmed COPD and vocal cord dysfunction is needed to be particular interest in differential diagnosis. Triggering factors such as smoking, atopy, work place condition and aspirin hypersensitivity should be evaluated. Comorbidities that may affect asthma should be considered. This review examines the definition of asthma, its differential diagnosis, phenotypes and available treatment options.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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| APA | BEYHAN SAGMEN S, CEYHAN B (2018). ZOR ASTIM. , 157 - 163. |
| Chicago | BEYHAN SAGMEN SEDA,CEYHAN Berrin ZOR ASTIM. (2018): 157 - 163. |
| MLA | BEYHAN SAGMEN SEDA,CEYHAN Berrin ZOR ASTIM. , 2018, ss.157 - 163. |
| AMA | BEYHAN SAGMEN S,CEYHAN B ZOR ASTIM. . 2018; 157 - 163. |
| Vancouver | BEYHAN SAGMEN S,CEYHAN B ZOR ASTIM. . 2018; 157 - 163. |
| IEEE | BEYHAN SAGMEN S,CEYHAN B "ZOR ASTIM." , ss.157 - 163, 2018. |
| ISNAD | BEYHAN SAGMEN, SEDA - CEYHAN, Berrin. "ZOR ASTIM". (2018), 157-163. |
| APA | BEYHAN SAGMEN S, CEYHAN B (2018). ZOR ASTIM. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, 19(4), 157 - 163. |
| Chicago | BEYHAN SAGMEN SEDA,CEYHAN Berrin ZOR ASTIM. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi 19, no.4 (2018): 157 - 163. |
| MLA | BEYHAN SAGMEN SEDA,CEYHAN Berrin ZOR ASTIM. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, vol.19, no.4, 2018, ss.157 - 163. |
| AMA | BEYHAN SAGMEN S,CEYHAN B ZOR ASTIM. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi. 2018; 19(4): 157 - 163. |
| Vancouver | BEYHAN SAGMEN S,CEYHAN B ZOR ASTIM. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi. 2018; 19(4): 157 - 163. |
| IEEE | BEYHAN SAGMEN S,CEYHAN B "ZOR ASTIM." Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, 19, ss.157 - 163, 2018. |
| ISNAD | BEYHAN SAGMEN, SEDA - CEYHAN, Berrin. "ZOR ASTIM". Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi 19/4 (2018), 157-163. |
