Deslée Gaëtan
Service de pneumologie, Inserm UMRS 1250, CHU de Reims, Reims, France.
Rev Prat. 2024 May;74(5):533-536.
WHAT ARE THE INDICATIONS FOR CORTICOSTEROID THERAPY IN COPD? In stable state chronic obstructive pulmonary disease (COPD), inhaled corticosteroids (ICS) should be used in case of frequent exacerbation only, associated with long-term bronchodilators including long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA). When frequent exacerbations persist despite dual inhaled therapy (LABA + CSI or LABA+LAMA), triple inhaled therapy (LAMA+LABA+CSI) is indicated. In COPD exacerbation, the level of evidence for systemic corticosteroids is very low, justifying not to systematically prescribe systemic corticosteroids and when used to restrict this use to short-term (5 days) and low doses.
慢性阻塞性肺疾病（COPD）中糖皮质激素治疗的指征是什么？在稳定期慢性阻塞性肺疾病中，仅在频繁加重且伴有包括长效β受体激动剂（LABA）和长效毒蕈碱拮抗剂（LAMA）在内的长期支气管扩张剂的情况下，才应使用吸入性糖皮质激素（ICS）。当双重吸入治疗（LABA + CSI或LABA+LAMA）后仍频繁加重时，应采用三联吸入治疗（LAMA+LABA+CSI）。在COPD加重期，全身用糖皮质激素的证据水平非常低，这说明不应常规开具全身用糖皮质激素，如需使用应将其限制在短期（5天）和低剂量使用。
