哮喘与慢阻肺黏液栓的病理生物学及治疗：最新进展
本叙述性综述聚焦哮喘和慢阻肺中气道黏液栓的病理生物学，重点阐述其患病率与临床特征、形成与持续机制、当前及新兴治疗。近期CT研究显示黏液栓在哮喘和慢阻肺患者中高发，可在同一气道持续多年，且常发生于无咳嗽咳痰症状者；黏液栓与气流阻塞和疾病发病率强相关，并在高剂量吸入和口服糖皮质激素治疗下仍存在。
要点
- CT可识别哮喘和慢阻肺患者中高发的气道黏液栓。
- 黏液栓与气流阻塞和疾病发病率强相关，且对激素治疗抵抗。
- 黏液栓是哮喘和慢阻肺可特异性干预的潜在治疗靶点。
核心结论
- 气道黏液栓是哮喘和慢阻肺中未被充分认识的气道病理，可导致持续性气流阻塞和疾病发病率，并可成为特异性治疗靶点。
研究设计与样本
- 叙述性综述，基于近期CT研究等文献，聚焦哮喘和慢阻肺中黏液栓的病理生物学。
主要发现
- CT研究显示哮喘和慢阻肺患者中气道黏液栓患病率高。
- 黏液栓在同一气道持续多年，且常发生于无咳嗽咳痰症状的患者。
- 黏液栓与哮喘和慢阻肺的气流阻塞及疾病发病率强相关。
- 黏液栓在高剂量吸入和口服糖皮质激素治疗下仍出现并持续。
临床怎么用
- 临床应关注哮喘和慢阻肺患者气道黏液栓的识别与评估。
- 对激素治疗反应不佳的持续性气流阻塞需考虑黏液栓因素。
- 黏液栓可作为特异性治疗靶点进行干预研究。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
Recent studies using computed tomography have uncovered a high prevalence of airway mucus plugs in patients with asthma and COPD. These mucus plugs persist in the same airways for years and often occur in patients without symptoms of cough and sputum production. Mucus plugs associate strongly with measures of airflow obstruction and disease morbidity in both asthma and COPD, and they occur and persist despite treatment with high doses of inhaled and oral corticosteroids. Thus, airway mucus plugs have emerged as an underappreciated airway pathology in asthma and COPD and a cause of persistent airflow obstruction and disease morbidity that can be specifically targeted for treatment. This narrative review covers the pathobiology of mucus plugs in asthma and COPD with three areas of emphasis: 1) prevalence and clinical features; 2) mechanisms of formation and persistence; and 3) current and emerging treatments.
引用
- Fahy JV. The pathobiology and treatment of mucus plugs in asthma and COPD: state of the art. Eur Respir J. 2026. PMID: 41713949. doi:10.1183/13993003.02358-2025
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。