Fournier M, Jebrak G
Service de pneumologie et réanimation, Hôpital Beaujon, Clichy.
Rev Prat. 1995 May 15;45(10):1239-41.
There is no available drug which has been demonstrated to reverse the pathological lesions associated with chronic obstructive pulmonary disease, either at the bronchial or at the parenchymal level. Bronchodilators may improve dyspnea and exercise tolerance; in some patients, they may also decrease moderately airflow obstruction. Their benefit on the rate of decline of forced expiratory volume in one second has not been documented. In the same way, the regular use of inhaled steroids has not been shown to prevent or limit the degradation of pulmonary function. On the other hand, long term oxygen supply improves the life expectancy of patients with chronic hypoxemia. Antibiotic treatment of exacerbations is recommended; however, the rationale for its use is still a matter of debate.
目前尚无已证实能逆转与慢性阻塞性肺疾病相关的支气管或实质层面病理病变的药物。支气管扩张剂可改善呼吸困难和运动耐量;在某些患者中,它们还可能适度减轻气流阻塞。但它们对一秒用力呼气量下降速率的益处尚无文献记载。同样,长期使用吸入性类固醇尚未显示能预防或限制肺功能的恶化。另一方面,长期吸氧可提高慢性低氧血症患者的预期寿命。推荐对病情加重进行抗生素治疗;然而,其使用的理论依据仍存在争议。