康心摯友
  • 甚麼是嚴重哮喘?1-5




    參考:
    1. 1. What is severe asthma. Asthma UK. 2016. (Accessed on 12 Mar 2019, at https://www.asthma.org.uk/advice/severe-asthma/what-is-severe-asthma/)
    2. 2. Defining severe asthma. The Hong Kong Asthma Society. 2015. (Accessed on 12 Mar 2019, at http://www.hkasthma.org.hk/en/about-asthma/what-severe-asthma)
    3. 3. Lommatzsch M, Virchow CJ. Severe Asthma: Definition, Diagnosis and Treatment. Dtsch Arztebl Int. 2014;111(50):847-855.
    4. 4. Chipps BE, et al. Key findings and clinical implications from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. J Allergy Clin Immunol.2012;130(2):332-342.
    5. 5. Carr TF, et al. Eosinophilic bioactivities in severe asthma. World Allergy Organ J. 2016;9:21.
  • 如何得知自己是否患有嚴重哮喘?2,3




    參考:
    1. 2. Defining severe asthma. The Hong Kong Asthma Society. 2015. (Accessed on 12 Mar 2019, at http://www.hkasthma.org.hk/en/about-asthma/what-severe-asthma)
    2. 3. Lommatzsch M, Virchow CJ. Severe Asthma: Definition, Diagnosis and Treatment. Dtsch Arztebl Int. 2014;111(50):847-855.
  • 嚴重哮喘可如何治理?6


    除患者本來使用的長效氣管舒張劑和吸入式類固醇外,現時亦有針對個別機制反應的新型藥物,作為附加藥物使用:

    抗免疫球蛋白E治療

    此機制是藥物結合在IgE抗體的Fc部位,預防IgE和巨大細胞及嗜鹼性粒細胞結合,而減少過敏反應的介質分泌。7


    抗嗜酸性粒細胞藥物
    1. 抗IL-5
      此生物製劑會在體內結合游離的IL-5,防止IL-5與嗜酸性白血球表面上的IL-5受體α鏈結合,降低嗜酸性白血球的產生和存活。7
    2. 抗IL-5Rα

      抗IL-5Rα生物製劑會與嗜酸性白血球上的IL-5受體結合,吸引一些免疫效應細胞如自然殺手(NK)細胞接近嗜酸性白血球。這些自然殺手(NK)細胞可以殺死嗜酸性白血球,令它門凋亡。7

      現時新型的抗IL-5Rα已有良好的數據支持,可以減低高達一半的嚴重哮喘發病次數。8


    此外,氣道大幅受阻的嚴重哮喘患者,您的醫生可能建議您考慮接受支氣管熱成形術,減薄平滑肌細胞6

    參考:
    1. 6. How is severe asthma treated? Asthma UK. 2017. (Accessed on 12 Mar 2019, at https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/how-is-severe-asthma-treated/)
    2. 7. Biological treatments for severe asthma: A major advance in asthma care, Busse, William W., Allergology International, Volume 68, Issue 2, 158 – 166
    3. 8. Farne HA, et al, Anti-IL5 therapies for asthma. Cochrane Database Syst Rev,2017;9:Cd010834
  • 你曾否出現以下情況?


    嚴重哮喘問卷評估9


     
     
     
     

    提交評估


    參考:
    1. 9. This information may help you and your asthma specialist e-valuate if your asthma is e-asthma (eosinophilic asthma). AstraZeneca. (Accessed on 18 Apr 2019 at https://www.easthma.com/pdf/DoctorDiscussion.pdf)
  • 嚴重哮喘小貼士10


    嚴重哮喘雖然棘手,但只要患者遵從以下小貼士,便能有效控制徵狀



    參考:
    1. 10. Manage your severe asthma. Asthma UK. 2016. (Accessed on 12 Mar 2019, at https://www.asthma.org.uk/advice/severe-asthma/managing-severe-asthma/manage-your-severe-asthma/)

HK-3025 22/10/2019