在COPD患者中使用三重疗法的临床概念:德尔菲共识
Marc Miravitlles1, Sudeep Acharya2, Bhumika Aggarwal2
1Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
International journal of chronic obstructive pulmonary disease
|September 4, 2023
概括
三重疗法为慢性阻塞性肺病 (COPD) 管理提供了好处,包括减少恶化和与单个吸入器三重疗法 (SITT) 相比的肺炎风险. 专家们一致认为,SITT适用于高胆固醇细胞计数和住院后早期启动.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床实践指南 临床实践指南
背景情况:
- 越来越多的证据支持慢性阻塞性肺病 (COPD) 管理中的三重疗法.
- 关于三重疗法的最佳使用,益处和风险的共识仍然有限.
研究的目的:
- 为了在COPD管理中的三重疗法的作用上达成专家共识.
- 评估对减轻恶化的影响,早期优化,肺炎风险和死亡率的好处.
主要方法:
- 一项为期两轮的德尔菲调查,涉及来自10个国家的21名呼吸专家.
- 一份由31个陈述组成的问卷,使用9点的利克特级别进行评估,共识值为75%.
- 在网上调查和参与者会议后分析了回复.
主要成果:
- 在单个和多个吸入器三重疗法 (SITT/MITT) 之间的死亡益处,肺炎风险比较方面达成共识.
- 专家们更喜欢SITT,因为它具有高的乙氨基酸计数 (95%) 和在住院后的早期启动 (86%).
- 在初始COPD诊断恶化后,对第一线SITT使用没有共识.
结论:
- 关于使用三重疗法的关键方面以及COPD的益处,专家们已经达成共识.
- 需要进一步的证据来评估早期三重疗法优化的好处.
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