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[外源性过敏性肺泡炎急性、亚急性和慢性变体的新治疗方案]

[New therapy schemes for acute, subacute and chronic variants of extrinsic allergic alveolitis].

作者信息

Makar'iants N N, Shmelev E I

出版信息

Vestn Ross Akad Med Nauk. 2012(11):39-44.

PMID:23457980
Abstract

In order to improve treatment of patients with exogenous allergic alveolitis morphologically different variants of the disease, i.e. acute, subacute and chronic were identified and confirmed. For each variant of exogenous allergic alveolitis new therapy schemes were proposed. The study included 74 patients who were divided into 5 groups. In the first group with acute exogenous allergic alveolitis inhalation glycocorticosteroids in high doses in combination with plasmapheresis were prescribed, in the second group standard therapy with systemic glycocorticosteroids was prescribed. The third and the fourth group consisted of patients with subacute exogenous allergic alveolitis. The protracted ambroxol inhalation using nebulizers and the reduced dose of systemic glycocorticosteroids were used in the third group; and the standard dose of systemic glycocorticosteroids was used in the fourth. The fifth group consisted of patients with chronic exogenous allergic alveolitis, who received the standard dose of glycocorticosteroids and cytostatic drugs. After one month of therapy, it was ascertained that the use of high doses of inhalation glycocorticosteroids in combination with plasmapheresis in patients with acute exogenous allergic alveolitis led to significant improvements in clinical and CT presentation, physical activity tolerance, as well as the use of systemic glycocorticosteroids. The use of ambroxol inhalation in patients with subacute exogenous allergic alveolitis led to a significant improvement in clinical symptomatology, functional parameters and CT presentation, thus enabling to reduce the dose of glycocorticosteroids used and to avoid unwanted side effects.

摘要

为了改善对外源性过敏性肺泡炎形态学不同变体患者的治疗,即识别并确认了该疾病的急性、亚急性和慢性变体。针对外源性过敏性肺泡炎的每种变体,都提出了新的治疗方案。该研究纳入了74例患者,他们被分为5组。第一组急性外源性过敏性肺泡炎患者采用高剂量吸入糖皮质激素联合血浆置换治疗,第二组采用全身糖皮质激素标准治疗。第三组和第四组由亚急性外源性过敏性肺泡炎患者组成。第三组使用雾化器持续吸入氨溴索并减少全身糖皮质激素剂量;第四组使用全身糖皮质激素标准剂量。第五组由慢性外源性过敏性肺泡炎患者组成,他们接受标准剂量的糖皮质激素和细胞毒性药物治疗。治疗一个月后,确定在急性外源性过敏性肺泡炎患者中使用高剂量吸入糖皮质激素联合血浆置换可显著改善临床和CT表现、身体活动耐量以及全身糖皮质激素的使用情况。在亚急性外源性过敏性肺泡炎患者中使用氨溴索吸入可显著改善临床症状、功能参数和CT表现,从而能够减少所用糖皮质激素的剂量并避免不良副作用。

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