治疗慢性阻塞性肺疾病气道黏液高分泌临床意义 - 中国实用医学杂志社.pdf

382 Chinese Journal of Practical Internal Medicine May 2015 Vol. 35 No. 5 • 专题笔谈 慢性阻塞性肺疾病特异性治疗 治疗慢性阻塞性肺疾病气道黏液高分泌 临床意义 田攀文，文富强 DOI：10.7504/nk2015040102 中图分类号：R562 文献标志码：A 摘要 ：气道黏液高分泌是慢性阻塞性肺疾病 ( 简称慢阻肺 ) 的重要病理生理特征之一。慢阻肺患者的气道黏液高分 泌可加速患者肺功能下降、导致患者生活质量变差、急性加重频率增加、住院率和病死率升高。针对慢阻肺患者气道 黏液高分泌的治疗包括非药物治疗和药物治疗。非药物治疗措施为戒烟和物理康复治疗。药物治疗包括祛痰剂和 黏液溶解剂、甲基黄嘌呤和 β 受体激动剂、抗胆碱药、糖皮质激素、磷酸二酯酶 4 抑制剂、抗氧化剂和大环内酯类抗 生素等。一些新药正处在临床研究阶段，已显示出治疗前景。 关键词 ：肺疾病，慢性阻塞性 ；黏液高分泌 Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease. TIAN Pan-wen, WEN Fu- qiang. Department of Respiratory, West China Hospital Sichuan University, Chengdu 610041, China Corresponding author: WEN Fu-qiang, E-mail: wenfuqiang@126.com Abstract: Mucus hypersecretion is one of the most important features of the chronic obstructive pulmonary disease(COPD). Mucus hypersecretion in COPD patients results in several important outcomes such as rapid decline of lung function, poor quality of life, and high rate ofexacerbations, hospitalizations and mortality. Non-pharmacologic treatments for mucus hypersecretion in COPD include smoking cessation and physical rehabilitation. Pharmacologic therapies include expectorants, mucolytics, methylxanthines, beta-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics. Novel drugs are currently used in clinical trials,showing promising propects. Keywords: pulmonary disease, chronic obstructive; mucus hypersecretion 文富强，主任医师、教授、博士生 或气体慢性异常炎症反应有关。世界卫生组织估计 导师。工作于四川大学华西医院呼吸 全球慢阻肺患者人数已超过 2 亿，并预测到 2030 年， 科。兼任美国胸科学会临床委员会委 慢阻肺将是全球第三位疾病死亡原因 [1] 。气道黏液 员、美国胸科医师协