[在BPCO中使用皮质疗法有哪些迹象?]
1Service de pneumologie, Inserm UMRS 1250, CHU de Reims, Reims, France.
La Revue du praticien
|June 4, 2024
概括
吸入性皮质类固醇 (ICS) 建议用于常见的慢性阻塞性肺病 (COPD) 恶化以及长效支气管扩展剂. 系统性皮质类固醇治疗COPD恶化应少量,短期,低剂量使用,因为证据有限.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性阻塞性肺病 (COPD) 的管理通常涉及解决恶化.
- 皮质类固醇在COPD治疗中发挥作用,但它们的最佳使用需要澄清.
研究的目的:
- 确定COPD吸入和全身皮质类固醇治疗的指示.
- 提供关于在稳定的COPD和恶化期间适当使用皮质类固醇的指导.
主要方法:
- 审查当前的指导方针和证据,关于在COPD使用皮质类固醇.
- 分析稳定性COPD的治疗策略,频繁恶化.
- 评估证据支持系统性皮质类固醇在COPD恶化中的使用.
主要成果:
- 吸入性皮质类固醇 (ICS) 适用于稳定的COPD,频繁恶化,并与长效β-激动剂 (LABA) 和长效肌抗体 (LAMA) 一起使用.
- 当双重疗法无法控制频繁的恶化时,建议使用三重吸入疗法 (LAMA+LABA+ICS).
- 在COPD恶化中系统性皮质类固醇的证据非常低,支持限制,短期 (5天),低剂量使用.
结论:
- 吸入性皮质类固醇对特定的COPD患者群体有好处,这些患者经常出现恶化.
- 在COPD恶化中,系统性皮质类固醇的使用应该是明智的和有限的.
- 目前的证据支持在COPD治疗中采取逐步的皮质类固醇治疗方法.
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