ACP Medicine
نویسندگان
چکیده
Asthma is characterized by narrowing of the airways in response to various stimuli and the presence of airway inflammation of varying degree. Unlike the more fixed or permanent airflow obstruction typical of chronic bronchitis, emphysema, cystic fibrosis, bronchiectasis, and bronchiolitis, the airflow obstruction associated with asthma may be completely reversible [see 14:III Chronic Obstructive Diseases of the Lung]. Asthma is a chronic disease, yet the degree of airflow obstruction can vary widely over time and change within minutes or over a period of days to weeks. Increased responsiveness of the airways to various stimuli is seen even in asymptomatic asthma patients who have normal lung function. Increased responsiveness of the airways and reversible airflow obstruction are not unique to asthma. Many patients with chronic obstructive lung disease (e.g., chronic bronchitis or cystic fibrosis) exhibit nonspecific hyperresponsiveness, although obstruction is not completely reversible and some degree of obstruction is always present. In particular, some current or past cigarette smokers with chronic bronchitis and airflow obstruction exhibit episodic wheezing and shortness of breath that closely mimic asthma. There is no consensus on how such patients should be classified, but we prefer to consider their ailment not as asthma but as asthmatic bronchitis, a subcategory of chronic bronchitis that has features in common with asthma [see 14:III Chronic Obstructive Diseases of the Lung]. This distinction is important in studies of the prevalence and mortality of asthma. There is no single pathognomonic feature by which asthma may be recognized, nor is there a definitive diagnostic test for asthma. Many clinical settings, such as wheezing in association with childhood respiratory tract infections and long-standing asthma in adults with irreversible obstruction, defy straightforward classification. Fortunately, in clinical practice, asthma is generally far easier to recognize than it is to define.
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تاریخ انتشار 2003