小児における気管支拡張症：診断と治療

[title]

Bronchiectasis in children: diagnosis and treatment.

[author]

Chang AB, et al. Lancet. 2018.

[Abstract]
Bronchiectasis is conventionally defined as irreversible dilatation of the bronchial tree. Bronchiectasis unrelated to cystic fibrosis is an increasingly appreciated cause of chronic respiratory-related morbidity worldwide. Few randomised controlled trials provide high-level evidence for management strategies to treat the children affected by bronchiectasis. However, both decades-old and more recent studies using technological advances support the notion that prompt diagnosis and optimal management of paediatric bronchiectasis is particularly important in early childhood. Although considered to be of a non-reversible nature, mild bronchiectasis determined by radiography might be reversible at any age if treated early, and the lung function decline associated with disease progression could then be halted. Although some management strategies are extrapolated from cystic fibrosis or adult-based studies, or both, non-cystic fibrosis paediatric-specific data to help diagnose and manage these children still need to be generated. We present current knowledge and an updated definition of bronchiectasis, and review controversies relating to the management of children with bronchiectasis, including applying the concept of so-called treatable traits.

[memo]
■知らない

Bronchiectasis :気管支拡張症

dilatation :膨張

cystic fibrosis :嚢胞性繊維症

appreciated :認識された

morbidity :病的状態

prompt :迅速な

optimal :最適な

decades-old :数十年にわたる

a non-reversible nature :非可逆的な性質

radiography :x線撮影

decline :減少

halt :停止する

extrapolate :外挿法によって推定する

controversies :論争

traits :特徴

■使いたい

Few randomised controlled trials provide high-level evidence

high-level evidence for management strategies to treat the children

the children affected by bronchiectasis

still need to be generated