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以及肺康复:从新型药物治疗方法到肺结核后遗症的管理

and Pulmonary Rehabilitation: From Novel Pharmacotherapeutic Approaches to Management of Post-Tuberculosis Sequelae.

作者信息

Meca Andreea-Daniela, Mititelu-Tarțău Liliana, Bogdan Maria, Dijmarescu Lorena Anda, Pelin Ana-Maria, Foia Liliana Georgeta

机构信息

Department of Pharmacology, Faculty of Pharmacy, University of Medicine and Pharmacy, 200349 Craiova, Romania.

Department of Pharmacology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

出版信息

J Pers Med. 2022 Apr 2;12(4):569. doi: 10.3390/jpm12040569.

DOI:10.3390/jpm12040569
PMID:35455684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9027178/
Abstract

Tuberculosis (TB) is still a worldwide public health burden, as more than 1.3 million deaths are expected to be reported in 2021. Even though almost 20 million patients have completed specific anti-TB treatment and survived in 2020, little information is known regarding their pulmonary sequelae, quality of life, and their need to follow rehabilitation services as researchers shifted towards proper diagnosis and treatment rather than analyzing post-disease development. Understanding the underlying immunologic and pathogenic mechanisms during mycobacterial infection, which have been incompletely elucidated until now, and the development of novel anti-TB agents could lead to the proper application of rehabilitation care, as TB sequelae result from interaction between the host and . This review addresses the importance of host immune responses in TB and novel potential anti-TB drugs' mechanisms, as well as the assessment of risk factors for post-TB disease and usefulness of guidance and optimization of pulmonary rehabilitation. The use of rehabilitation programs for patients who successfully completed anti-tuberculotic treatment represents a potent multifaceted measure in preventing the increase of mortality rates, as researchers conclude that a patient with a TB diagnosis, even when properly completing pharmacotherapy, is threatened by a potential life loss of 4 years, in comparison to healthy individuals. Dissemination of pulmonary rehabilitation services and constant actualization of protocols could strengthen management of post-TB disease among under-resourced individuals.

摘要

结核病(TB)仍然是一项全球性的公共卫生负担,预计2021年将报告超过130万例死亡病例。尽管在2020年近2000万患者完成了特定的抗结核治疗并存活下来,但关于他们的肺部后遗症、生活质量以及他们对康复服务的需求却知之甚少,因为研究人员将重点转向了正确的诊断和治疗,而非分析疾病后的发展情况。了解分枝杆菌感染期间尚未完全阐明的潜在免疫和致病机制,以及开发新型抗结核药物,可能会促使康复护理的合理应用,因为结核病后遗症是由宿主与病原体之间的相互作用导致的。本综述阐述了宿主免疫反应在结核病中的重要性、新型潜在抗结核药物的作用机制,以及结核病后疾病危险因素的评估和肺部康复指导与优化的效用。对成功完成抗结核治疗的患者使用康复计划,是预防死亡率上升的一项有力的多方面措施,因为研究人员得出结论,与健康个体相比,结核病确诊患者即使正确完成药物治疗,仍有4年的潜在生命损失风险。推广肺部康复服务并不断更新方案,可加强资源匮乏人群中结核病后疾病的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/f08e54cf8b5a/jpm-12-00569-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/30cb6f4475e5/jpm-12-00569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/78bc1262d11c/jpm-12-00569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/f08e54cf8b5a/jpm-12-00569-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/30cb6f4475e5/jpm-12-00569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/78bc1262d11c/jpm-12-00569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bb/9027178/f08e54cf8b5a/jpm-12-00569-g003.jpg

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