在患有慢性阻塞性肺病恶化而入院的患者中使用葡萄糖皮质类药物
Songsong Yu1, Shuang Li2, Jie Zhang3
1Department of Emergency, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.
International journal of chronic obstructive pulmonary disease
|February 19, 2024
概括
更新的指导方针改善了在慢性阻塞性肺病 (AECOPD) 患者急性恶化的葡萄糖皮质激素的使用. 这导致1年复发率显著降低,改善了患者的治疗结果.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 药物治疗 药物治疗
背景情况:
- 系统性皮质糖类药物对于管理慢性阻塞性肺病 (AECOPD) 的急性恶化至关重要.
- 在AECOPD中,医生对葡萄糖皮质类药物的处方模式可能会有所不同.
- 2017年的GOLD和ERS/ATS指南旨在优化COPD管理.
研究的目的:
- 在2017年指南更新之前和之后,对AECOPD患者的葡萄糖皮质激素使用进行调查.
- 确定影响医生关于全身葡萄皮质激素处方的决定的因素.
- 评估指南更新对AECOPD复发率的影响.
主要方法:
- 来自两个时期的AECOPD患者数据的回顾性分析:2017年之前和2017年后的指南更新.
- 描述性统计数据以说明葡萄糖皮质激素使用模式.
- 假设测试用于比较两个时期之间的结果和影响因素.
主要成果:
- 吸入性皮质类固醇 (ICS) 的使用略有下降,从81.6% (2010-2016) 降至75.4% (2017-2020).
- 影响处方的因素包括COPD严重程度,喘,中性粒细胞计数和PaCO2水平,期间之间存在差异.
- 一年复发率显著下降,从32.4%降至20.9% (P<0.001).
结论:
- 2017年ERS/ATS关于COPD的指南与AECOPD中优化系统性皮质糖类药物的使用相关联.
- 这种优化与AECOPD患者1年复发率的降低有关.
- 指南的更新通过完善治疗策略,对患者的治疗结果产生了积极的影响.
更多相关视频
相关概念视频
01:26COPD: Management Using Bronchodilators and Corticosteroids
206
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
206
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
119
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
119
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
247
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
247
01:29Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K
01:22Chronic Obstructive Pulmonary Disease
1.2K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.2K
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
2.8K
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
2.8K