哮喘病情分期和严重程度分级管理ppt课件.ppt

* Patients were asked to describe as clearly as possible exactly what the ’signs’ or ’warnings’ were. Majority identified ’shortness of breath/getting breathless’ as a sign of asthma worsening. * Patients were asked whether there were any ’signs’ or ’warning’s that they were about to experience an asthma attack. Sixty per cent of patients answered positively. Base: All respondents (n=2,406) * Patients were asked to state the length of time between initial signs or warnings and when symptoms start to become bothersome/between bothersome symptoms and when symptoms are at their worst/between symptoms at their worst and recovery. Base: All Respondents who noticed signs or warnings (n=1,596)/ all respondents (n=2,407) The mean period from the early signs to the peak symptoms of a worsening was 6 days. This gradual development has also been noted and evaluated in the FACET study1, where exacerbations were characterized by a gradual increase in symptoms over 5 to 7 days, followed by a more rapid increase over 2 to 3 days. 1 Tattersfield AE, Postma DS, Barnes PJ, Svensson K, Bauer C-A, OByrne PM, L?fdahl C-G, Pauwels RA, Ullman A. Exacerbations of asthma - a descriptive study of 425 severe exacerbations. American Journal of Respiratory and Critical Care Medicine 1999;160(2):594-9. * The figure shows the mean number of puffs of SABA per day taken at different stages during a worsening, compared with the number of puffs of ICS. Regardless of the type of maintenance treatment, patients main response to an impending worsening is to increase the dose of SABA; they do this earlier and to a greater extent than for ICS. ICS is increased when symptoms are at there worst and therefore too late. * Patients were asked to state the length of time between initial signs or warnings and when symptoms start to become bothersome/between bothersome symptoms and when symptoms are at their worst/between symptoms at their worst and recovery. Base: All Respondents who noticed signs or