COPD早期药物干预和非常规药物治疗进展及热点扫描  

Progress and Hot Issues of Early Medical Interference and Non-conventional Pharmacologic Therapies in Treatment of Chronic Obstructive Pulmonary Disease(COPD)

作　　者：罗勇[1,2] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院呼吸科,上海202150 [2]上海交通大学医学院附属新华医院呼吸科,上海200092

出　　处：《临床误诊误治》2012年第8期8-12,共5页Clinical Misdiagnosis & Mistherapy

基　　金：上海市慢性病综合防治项目(SHDC12007301)

摘　　要：慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是人类最重要的致死性和致残性疾病之一,但是除了吸入支气管舒张剂和糖皮质激素外,其他真正有效的治疗药物非常有限。本文探讨了Ⅰ级和Ⅱ级COPD患者应用长效支气管舒张剂治疗的必要性,以及抗氧化剂、维生素D、大环内酯类抗生素治疗COPD的机制、争议和进展;也展望了一些COPD新药开发的切入点,如阻断气道的炎症反应通路、肺泡上皮细胞修复等,并指出单独使用肺功能检查作为COPD诊断、评估和治疗的手段价值有限,可进一步识别COPD的表型来指导COPD的治疗。Chronic Obstructive Pulmonary Disease（COPD） is one of most important lethal and disabling diseases in human beings, but its effective treatments are limited except by bronchodilators and glueocorticoids. This paper discusses the necessity of long acting hronchodilators therapies in Stage Ⅰ and Ⅱ in COPD, as well as some mechanisms, controversy and advances of non-conventional pharmacologic therapies such as antioxidants, Vitamin D and macrolide antibiotics in patients with COPD. The paper also forecasts some new pharmacologic targets in treatment of COPD, such as inflammatory pathway blockade and alveolar epithelial cell repair. The paper points out that because of limited value in measures of diagnosis, and assessment, it is necessary to treat COPD according to single lung function parameter, and phenotype of COPD, which is helpful in directing treatment of COPD.

关 键 词：肺疾病 慢性阻塞性 药物疗法 

分 类 号：R563.9[医药卫生—呼吸系统]