激素在慢性阻塞性肺疾病急性加重期的应用

Corticosteroids Therapy for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

在慢性阻塞性肺疾病急性加重期中,激素治疗是一个很普遍的治疗方案。很多研究表明,激素可以缩短康复时间、改进肺功能,并降低早期复发的风险、减少治疗失败的概率和缩短住院时间。该治疗方案在一定程度上存有争议,因为激素治疗存在严重的不良反应,且各种随机对照临床试验就其剂量、疗程和给药方式的研究结果也不尽相同。最佳的初始治疗为低剂量,疗程不超过2周,但具体剂量和天数未明;雾化吸入可作为全身给药的替代疗法,但远期疗效需进一步研究。

The corticosteroids therapy for patients with exacerbation of chronic obstruction pulmonary disease （COPD） has become common practice.A number of studies have indicated that corticosteroids in COPD exacerbations can shorten the recovery time,improve the lung function,and reduce the risk of early relapse,treatment failure,and the length of hospital stay.However,this practice remains controversial due to the serious adverse effects,besides,various studies of randomized clinical trials show different results about dose,duration and mode of administration.The optimal stating dose of corticosteroids is low dose,and the duration should not be longer than two weeks,but the specific dose and days are still unclear.Although nebulized corticosteroids may be an ahernative to systemic treatment,future studies should be done to evaluate the longterm impact.