支氣管擴張癥的抗生素治療_《中國呼吸與危重監護雜志》

作者：

朱硯萍 , 瞿介明

復旦大學附屬華東醫院呼吸內科(上海200040);

關鍵詞：

支氣管擴張癥抗生素治療

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支氣管擴張癥(簡稱支擴)是指由多種原因引起支氣管壁肌肉和彈力支撐組織的破壞而引起的中等大小支氣管的不正常擴張，是一種肺組織結構破壞性疾病，表現為反復呼吸道感染，大量膿痰，可出現咯血。支擴有許多相關因素及病因，總體來說，其發生可歸結于以下兩個因素：① 感染的持續刺激；②氣道阻塞、支氣管引流功能損害和防御功能的缺陷。兩種因素可以同時存在，互為因果。支擴的病程一般呈進行性發展，其機制可用Cole[1] 在1984年提出的惡性循環(vicious circle)假說來解釋，該假說認為感染或定植的細菌觸發氣道上皮的炎癥反應，釋放炎癥介質和酶，持續的慢性炎癥反應引起支氣管壁和肺組織的損傷，破壞氣道纖毛上皮的清潔功能，進一步加重感染和細菌定植，形成一個周而復始的惡性循環。因此，抗生素幾乎是現階段治療支擴的主要藥物之一。

引用本文： 朱硯萍,瞿介明. 支氣管擴張癥的抗生素治療. 中國呼吸與危重監護雜志, 2007, 6(3): 161-162. doi: 復制

1.	Cole PJ.A new look at the pathogenesis，management of persistent bronchial sepsis：a ‘vicious circle’hypothesis and its logical therapeutic connotations.In：Davies RJ，editor.Strategies for the management of chronic bronchial sepsis.Oxford：Medicine Publishing Foundation，1984，1-20.
2.	Barker AF. Bronchiectasis.N Engl J Med，2002，346.：1383-1393.
3.	Pasteur MC, Helliwell SM, Houghton SJ,et al. An investigation into causative factors in patients with bronchiectasis .Am J Respir Crit Care Med，2000，162：1277-1284.
4.	O’Donnell AE, Barker AF, Ilowite JS, et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. rhDNase Study Group.Chest，1998，113：1329-1334.
5.	Bilton D, Henig N, Morrissey B, et al. Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis. Chest, 2006;130:1503-1510.
6.	Wallace RJ，Glassroth J，Griffith DE，et al.Diagnosi and treatment of disease caused by nontuberculous mycobacteria.Am J Respir Crit Care Med，1997，156(Suppl)：1-25.
7.	Stevens DA，Schwartz HJ，Lee JY，et al. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis.N Engl J Med，2000，342：756-762.
8.	Tsang KW，Ho PI，Chan KN，et al. A pilot study of low-dose erythromycin in bronchiectasis.Eur Respir J. 1999;13:361-364.
9.	Rayner CF，Tillotson G，Cole PJ，et al. Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis. J Antimicrob Chemother. 1994 Jul;34(1):149-56..
10.	Stockley RA, Hill SL, Morrison HM. Effect of antibiotic treatment on sputum elastase in bronchiectatic outpatients in a stable clinical state.Thorax. 1984 Jun;39(6):414-9.
11.	Hill SL，Burnett D，Hewetson KA，et al. The response of patients with purulent bronchiectasis to antibiotics for four months. Q J Med,1988;66:163-73.

1. Cole PJ.A new look at the pathogenesis，management of persistent bronchial sepsis：a ‘vicious circle’hypothesis and its logical therapeutic connotations.In：Davies RJ，editor.Strategies for the management of chronic bronchial sepsis.Oxford：Medicine Publishing Foundation，1984，1-20.
2. Barker AF. Bronchiectasis.N Engl J Med，2002，346.：1383-1393.
3. Pasteur MC, Helliwell SM, Houghton SJ,et al. An investigation into causative factors in patients with bronchiectasis .Am J Respir Crit Care Med，2000，162：1277-1284.
4. O’Donnell AE, Barker AF, Ilowite JS, et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. rhDNase Study Group.Chest，1998，113：1329-1334.
5. Bilton D, Henig N, Morrissey B, et al. Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis. Chest, 2006;130:1503-1510.
6. Wallace RJ，Glassroth J，Griffith DE，et al.Diagnosi and treatment of disease caused by nontuberculous mycobacteria.Am J Respir Crit Care Med，1997，156(Suppl)：1-25.
7. Stevens DA，Schwartz HJ，Lee JY，et al. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis.N Engl J Med，2000，342：756-762.
8. Tsang KW，Ho PI，Chan KN，et al. A pilot study of low-dose erythromycin in bronchiectasis.Eur Respir J. 1999;13:361-364.
9. Rayner CF，Tillotson G，Cole PJ，et al. Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis. J Antimicrob Chemother. 1994 Jul;34(1):149-56..
10. Stockley RA, Hill SL, Morrison HM. Effect of antibiotic treatment on sputum elastase in bronchiectatic outpatients in a stable clinical state.Thorax. 1984 Jun;39(6):414-9.
11. Hill SL，Burnett D，Hewetson KA，et al. The response of patients with purulent bronchiectasis to antibiotics for four months. Q J Med,1988;66:163-73.

《中國呼吸與危重監護雜志》

支氣管擴張癥的抗生素治療

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《中國呼吸與危重監護雜志》

支氣管擴張癥的抗生素治療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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