吸入性糖皮质激素治疗不同类型慢性阻塞性肺疾病的临床获益

Benefit of inhaled corticosteroids in the treatment of different types of chronic obstructive pulmonary disease

慢性阻塞性肺疾病(简称慢阻肺)是临床上非常常见的一种疾病,病死率高,严重威胁广大患者的身体健康。吸入性糖皮质激素(ICS)是治疗该类疾病的常见药物之一,目前在临床上的使用有逐渐增加的趋势;尤其适用于第一秒用力呼气容积占预计值的百分比(FEV1%pred)<50%预计值或每年急性加重≥2次、住院≥1次的慢阻肺稳定期患者。但一系列相关研究表明,ICS虽然能降低慢阻肺患者未来急性加重风险,改善生活质量,但长期使用并不能降低患者的病死率,而且可能诱发肺炎、肺结核等一系列不良事件而使病情复杂化,加重患者的经济负担。因此,对于某些患者ICS应该权衡利弊,谨慎使用。

Chronic obstructive pulmonary disease（COPD） is a very common disease in the world. It has higher mortality and dose great harm to people＇s health. Inhaled corticosteroids（ICS） is popular with COPD patients and has an increased tendency to be used in clinic, especially for those with FEVl%pred〈$0% or ≥2 exacerbations per year or ≥ 1 hospital admission per year. However, a series of clinical researches have shown that although it decreases the risk of exacerbation and improves health status, it also fails to decrease the mortality in the long run. ICS use may also induce pneumonia, tuberculosis and so on, increasing the economical burden for the patients. So, before use oflCS, clinicians should balance the benefit against its side effects.