TY - JOUR T1 -严重哮喘的管理:欧洲188bet官网地址呼吸学会/美国胸科学会指引摩根富林明——欧洲呼吸杂志乔-和J - 10.1183/13993003.00588 -2019欧元六世55 - 1 SP - 1900588 AU -奥尔金,费尔南多AU - Cardet,胡安·卡洛斯AU - Chung, Kian风扇AU -潜水员,莎拉AU -费雷拉,第欧根尼s . AU -菲茨帕特里克,安妮盟,嘎嘎米娜AU - Kellermeyer,莉斯盟——Khurana认为,Sandhya盟——骑士Shandra盟——麦当劳,凡妮莎·m . AU -摩根,丽贝卡·l . AU -奥尔特加,Victor e . AU - Rigau大卫盟,苏巴拉奥Padmaja AU -妮娅,Thomy AU -爱德考克,伊恩m . AU -布,尤金·r . AU - Brightling克里斯盟——Boulet AU -卡巴纳,仅凭记性迈克尔AU -卡斯特罗,Mario AU - Chanez, Pascal AU - Custovic, Adnan AU - Djukanovic, Ratko AU - Frey, Urs AU - Frankemölle, Betty AU - Gibson, Peter AU - Hamerlijnck, Dominique AU - Jarjour, Nizar AU - Konno, Satoshi AU - Shen, Huahao AU - Vitary, Cathy AU - Bush，Andy Y1 - 2020/01/01 UR - //www.qdcxjkg.com/content/55/1/1900588.abstract N2 -本文档为严重哮喘的管理提供了临床建议。我们进行了综合证据合成，包括荟萃分析，以总结所有与欧洲呼吸学会/美国胸科学会工作组的问题相关的可用证据。188bet官网地址使用GRADE(建议分级、评估、发展和评价)方法对证据进行了评估，并在证据概要中总结了结果。由哮喘专家组成的多学科工作组对综合证据进行了讨论，并制定了建议，该工作组就6个具体问题提出了具体建议。在考虑了可取和不可取的后果、证据质量、可行性和各种干预措施的可接受性后，工作组提出了以下建议:1)建议使用抗白细胞介素(IL)-5和抗IL-5受体α治疗严重失控的成人嗜酸性粒细胞哮喘表型;2)建议使用血液嗜酸性粒细胞切点≥150 μL−1指导成人重症哮喘患者启动抗il -5; 3) suggest considering specific eosinophil (≥260 μL−1) and exhaled nitric oxide fraction (≥19.5 ppb) cut-offs to identify adolescents or adults with the greatest likelihood of response to anti-IgE therapy; 4) suggest using inhaled tiotropium for adolescents and adults with severe uncontrolled asthma despite Global Initiative for Asthma (GINA) step 4–5 or National Asthma Education and Prevention Program (NAEPP) step 5 therapies; 5) suggest a trial of chronic macrolide therapy to reduce asthma exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; and 6) suggest using anti-IL-4/13 for adult patients with severe eosinophilic asthma and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.The ERS/ATS Task Force makes recommendations on the use of novel therapies for severe asthma, specifically biologicals for type 2 high asthma, and antimuscarinic agents and macrolides, as well as on biomarkers for predicting treatment response http://bit.ly/2kZLRaD ER -