Management of bronchiectasis in adults
Management of bronchiectasis in adults
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DOI：
10.1183/09031936.00119114
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发表时间：
2015-05-01
影响因子：
24.3
通讯作者：
Blasi, Francesco
中科院分区：
文献类型：
--
作者：
Chalmers, James D.;Aliberti, Stefano;Blasi, Francesco
支气管扩张症以前被认为是一种罕见的疾病，现在越来越多地被认识到，对这种疾病的新兴趣正在刺激药物开发和临床研究。支气管扩张症是一系列感染性、遗传性、自身免疫性、发育性和过敏性疾病的最终共同途径，其病因、影响和预后具有高度异质性，治疗的目标应是：通过物理治疗或非物理治疗改善气道粘液清除，抑制、根除和预防气道细菌定植，减轻气道炎症，提高气道免疫功能。并改善身体功能和生活质量。幸运的是，越来越多的证据支持支气管扩张的干预措施。该领域已大大受益于引进的循证指南，在一些欧洲国家和随机对照试验已经证明了长期大环内酯类药物治疗的好处，吸入疗法，物理治疗和肺rehabilitation.This审查积累的证据提供了一个关键的更新管理支气管扩张症集中在新兴的证据和最近的随机对照试验。
Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials.