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COPD 中吸入疗法的应用进展。

An update on the use of inhaled therapy in COPD.

机构信息

Watford General Hospital, Watford, UK

City & Hackney GP Confederation, London, UK.

出版信息

Clin Med (Lond). 2018 Oct;18(5):387-390. doi: 10.7861/clinmedicine.18-5-387.

DOI:10.7861/clinmedicine.18-5-387
PMID:30287432
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6334108/
Abstract

Inhaled corticosteroids represent the mainstay of pharmacological treatment for reversible airways disease, and traditionally have had widespread use in non-reversible chronic obstructive pulmonary disease (COPD). However, use in this group may expose patients to an increased risk of pneumonia, without significant benefit to symptoms or exacerbation frequency. Here we provide a guide to the use of inhaled therapy in COPD for the general physician.

摘要

吸入性皮质类固醇是治疗可逆性气道疾病的主要药物,传统上广泛用于不可逆性慢性阻塞性肺疾病(COPD)。然而,在该人群中使用可能会增加患者患肺炎的风险,而对症状或加重频率没有显著益处。在这里,我们为普通医生提供了 COPD 吸入治疗的使用指南。

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An update on the use of inhaled therapy in COPD.COPD 中吸入疗法的应用进展。
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2
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The challenge of change: evidence, culture and expertise.变革的挑战:证据、文化与专业知识。
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本文引用的文献

1
Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD.COPD 患者每日一次单吸入器三联与双联治疗。
N Engl J Med. 2018 May 3;378(18):1671-1680. doi: 10.1056/NEJMoa1713901. Epub 2018 Apr 18.
2
A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease.关于在慢性阻塞性肺疾病的临床实践中撤回吸入性皮质类固醇的建议。
Respir Res. 2017 Nov 28;18(1):198. doi: 10.1186/s12931-017-0682-y.
3
Efficacy and safety of direct switch to indacaterol/glycopyrronium in patients with moderate COPD: the CRYSTAL open-label randomised trial.中度 COPD 患者直接换用茚达特罗/格隆溴铵的疗效和安全性:CRYSTAL 开放性随机试验。
Respir Res. 2017 Jul 18;18(1):140. doi: 10.1186/s12931-017-0622-x.
4
Withdrawal of inhaled corticosteroids in COPD: A meta-analysis.慢性阻塞性肺疾病中吸入性糖皮质激素的撤药:一项荟萃分析。
Pulm Pharmacol Ther. 2017 Aug;45:148-158. doi: 10.1016/j.pupt.2017.06.002. Epub 2017 Jun 9.
5
LABA/LAMA combinations versus LAMA monotherapy or LABA/ICS in COPD: a systematic review and meta-analysis.长效β2受体激动剂/长效毒蕈碱受体拮抗剂联合治疗与长效毒蕈碱受体拮抗剂单药治疗或长效β2受体激动剂/吸入性糖皮质激素治疗慢性阻塞性肺疾病的系统评价和荟萃分析
Int J Chron Obstruct Pulmon Dis. 2017 Mar 17;12:907-922. doi: 10.2147/COPD.S130482. eCollection 2017.
6
Blood Eosinophils and Response to Maintenance Chronic Obstructive Pulmonary Disease Treatment. Data from the FLAME Trial.血液嗜酸性粒细胞与维持治疗对慢性阻塞性肺疾病的反应。来自 FLAME 试验的数据。
Am J Respir Crit Care Med. 2017 May 1;195(9):1189-1197. doi: 10.1164/rccm.201701-0193OC.
7
Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial.停用吸入性皮质类固醇后严重慢性阻塞性肺病恶化与血嗜酸性粒细胞计数的关系:WISDOM 试验的事后分析。
Lancet Respir Med. 2016 May;4(5):390-8. doi: 10.1016/S2213-2600(16)00100-4. Epub 2016 Apr 7.
8
Blood Eosinophils and Exacerbations in Chronic Obstructive Pulmonary Disease. The Copenhagen General Population Study.血液嗜酸性粒细胞与慢性阻塞性肺疾病恶化。哥本哈根普通人群研究。
Am J Respir Crit Care Med. 2016 May 1;193(9):965-74. doi: 10.1164/rccm.201509-1869OC.
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Am J Respir Crit Care Med. 2015 Aug 15;192(4):523-5. doi: 10.1164/rccm.201502-0235LE.
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Lancet Respir Med. 2015 Jun;3(6):435-42. doi: 10.1016/S2213-2600(15)00106-X. Epub 2015 Apr 12.