吸入激素在支氣管擴張癥中的應用_Chinese Journal of Respiratory and Critical Care Medicine

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林勇

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吸入; 激素; 支氣管擴張癥

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支氣管擴張癥(簡稱支擴)是以進行性和不可逆性氣道破壞和擴張為特征的慢性氣道炎癥性疾病[1]，大多表現為長期咳嗽、咳膿性痰，反復急性發作，肺功能受損，后者主要表現為阻塞性通氣功能障礙，氣道反應性增高，晚期患者常常出現勞力性呼吸困難，嚴重影響患者生活質量[2,3] 。大部分支擴患者第1秒用力呼氣容積(FEV )每年下降大約50mL [4] 。在我國支擴的發病率為0.3‰～0.5‰。2005年美國成人支擴發病率約為52．3／100 000。發病率隨年齡而增加，在所有年齡階段女性發病率均較男性高，預計在美國有18歲以上的支擴患者110 000例，每年醫療費用約6．3億美元[5]。

Citation： 林勇. 吸入激素在支氣管擴張癥中的應用. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(3): 168-170. doi: Copy

1.	Cohen M，Sahn SA. Bronchiectasis in systemic diseases. Chest,1999;116:1063-1074.
2.	Wilson CB，Jones PW，O’Leary CJ，et al. Validation of the St. George’s Respiratory Questionnaire in bronchiectasis.Am J Respir Crit Care Med,1997;156:536-41.
3.	Martinez-Garcia MA，Perpina-Tordera M, Roman-Sanchez P, et al. Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest,2005,128:739-745.
4.	Ellis DA，Thornley PE，Wightman AJ，et al. Present outlook in bronchiectasis: clinical and social study and review of factors influencing prognosis.Thorax. 1981 Sep;36(9):659-64.
5.	Trow TK. Clinical year in review II: occupational lung disease, pulmonary vascular disease, bronchiectasis, and chronic obstructive pulmonary disease.Proc Am Thorac Soc. 2006 Sep;3(7):557-60.
6.	Tsang KW，Chan K，Ho P，et al.Sputum elastase in steady-state bronchiectasis.Chest 2000；117：420-6.
7.	Cole PJ. Inflammation: a two-edged sword--the model of bronchiectasis. Eur J Respir Dis Suppl. 1986；147(Suppl)：6-15.
8.	Barker AF.Bronchiectasis.N Engl J Med 2002；346：1383-93.
9.	Ho PL，Chan KN，Ip MS，et al. The effect of Pseudomonas aeruginosa infection on clinical parameters in steady-state bronchiectasis..Chest 1998；114：1594-8.
10.	Silva L，Jones JAH.，Cole PJ.，et al. The immunological component of the cellular inflammatory infiltrate in bronchiectasis.Thorax 1989.44：668-73.
11.	Gaga M，Bentley AM，Humbert M，et al.Increase in CD4+ T lymphocytes，macrophages，neutrophils and interleukin 8 positive cells in the airways of patients with bronchiectasis.Thorax 1998；53：685-91.
12.	Watt AP，Brown V，Courtney J，et al.Neutrophil apoptosis，proinflammatory mediators and cell counts in bronchiectasis.Thorax 2004；59：231-6.
13.	Richman-Eisenstat JB, Jorens PG, Hebert CA,et al. Interleukin-8: an important chemoattractant in sputum of patients with chronic inflammatory airway diseases.Am J Physiol 1993；264：413-8.
14.	Ho JC，Tipoe G，Zheng L，et al. In vitro study of regulation of IL-6 production in bronchiectasis.Respir Med. 2004 Apr;98(4):334-41.
15.	Amitani R, Wilson R, Rutman A,.et al. Effects of human neutrophil elastase and Pseudomonas aeruginosa proteinases on human respiratory epithelium.Am J Respir Cell Mol Biol. 1991 Jan;4(1):26-32.
16.	King PT，Hutchinson P，Holmes PW，et al. Assessing immune function in adult bronchiectasis. Clin Exp Immunol. 2006 Jun;144(3):440-446.
17.	Elborn JS, Johnston B, Allen F，et al. Inhaled steroids in patients with bronchiectasis.Respir Med. 1992 Mar;86(2):121-4.
18.	Tsang KW, Ho PL, Lam WK,.et al. Inhaled fluticasone reduces sputum inflammatory indices in severe bronchiectasis.Am J Respir Crit Care Med. 1998 Sep;158(3):723-7.
19.	Tsang KW, Tan KC, Ho PL, ，et al：Exhaled nitric oxide in bronchiectasis: the effects of inhaled corticosteroid therapy，Int J Tuberc Lung Dis. 2004 Nov;8(11):1301-7.
20.	Tsang KW，Tan KC，Ho PL，et al. Inhaled fluticasone in bronchiectasis: a 12 month study.Thorax. 2005 Mar;60(3):239-43.
21.	Chan SL, Chan-Yeung MM, Ooi GC, et al. Validation of the Hong Kong Chinese version of the St. George Respiratory Questionnaire in patients with bronchiectasis.Chest. 2002 Dec;122(6):2030-7.
22.	Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P, Soler-Cataluna JJ.，et al.Inhaled steroids improve quality of life in patients with steady-state bronchiectasis.Respir Med. 2006 Sep;100(9):1623-32. Epub 2006 Jan 24.
23.	Lundgren JD, Shelhamer JH.. Pathogenesis of airway mucus hypersecretion.J Allergy Clin Immunol. 1990 Feb;85(2):399-417.
24.	Kharitonov SA, Wells AU, O’Connor BJ，et al. Elevated levels of exhaled nitric oxide in bronchiectasis. Am J Respir Crit Care Med. 1995 Jun;151(6):1889-93.
25.	Byrnes CA, Dinarevic S, Shinebourne EA.，et al. Exhaled nitric oxide measurements in normal and asthmatic children.Pediatr Pulmonol. 1997 Nov;24(5):312-8.
26.	Baraldi E, Azzolin NM, Zanconato S, et al. Corticosteroids decrease exhaled nitric oxide in children with acute asthma. J Pediatr. 1997 Sep;131(3):381-5.
27.	Kharitonov SA, Yates DH, Barnes PJ. Inhaled glucocorticoids decrease nitric oxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med. 1996 Jan;153(1):454-7..
28.	Tsang KW, Lam SK, Lam WK，et al. High seroprevalence of Helicobacter pylori in active bronchiectasis.Am J Respir Crit Care Med. 1998 Oct;158(4):1047-51.

1. Cohen M，Sahn SA. Bronchiectasis in systemic diseases. Chest,1999;116:1063-1074.
2. Wilson CB，Jones PW，O’Leary CJ，et al. Validation of the St. George’s Respiratory Questionnaire in bronchiectasis.Am J Respir Crit Care Med,1997;156:536-41.
3. Martinez-Garcia MA，Perpina-Tordera M, Roman-Sanchez P, et al. Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest,2005,128:739-745.
4. Ellis DA，Thornley PE，Wightman AJ，et al. Present outlook in bronchiectasis: clinical and social study and review of factors influencing prognosis.Thorax. 1981 Sep;36(9):659-64.
5. Trow TK. Clinical year in review II: occupational lung disease, pulmonary vascular disease, bronchiectasis, and chronic obstructive pulmonary disease.Proc Am Thorac Soc. 2006 Sep;3(7):557-60.
6. Tsang KW，Chan K，Ho P，et al.Sputum elastase in steady-state bronchiectasis.Chest 2000；117：420-6.
7. Cole PJ. Inflammation: a two-edged sword--the model of bronchiectasis. Eur J Respir Dis Suppl. 1986；147(Suppl)：6-15.
8. Barker AF.Bronchiectasis.N Engl J Med 2002；346：1383-93.
9. Ho PL，Chan KN，Ip MS，et al. The effect of Pseudomonas aeruginosa infection on clinical parameters in steady-state bronchiectasis..Chest 1998；114：1594-8.
10. Silva L，Jones JAH.，Cole PJ.，et al. The immunological component of the cellular inflammatory infiltrate in bronchiectasis.Thorax 1989.44：668-73.
11. Gaga M，Bentley AM，Humbert M，et al.Increase in CD4+ T lymphocytes，macrophages，neutrophils and interleukin 8 positive cells in the airways of patients with bronchiectasis.Thorax 1998；53：685-91.
12. Watt AP，Brown V，Courtney J，et al.Neutrophil apoptosis，proinflammatory mediators and cell counts in bronchiectasis.Thorax 2004；59：231-6.
13. Richman-Eisenstat JB, Jorens PG, Hebert CA,et al. Interleukin-8: an important chemoattractant in sputum of patients with chronic inflammatory airway diseases.Am J Physiol 1993；264：413-8.
14. Ho JC，Tipoe G，Zheng L，et al. In vitro study of regulation of IL-6 production in bronchiectasis.Respir Med. 2004 Apr;98(4):334-41.
15. Amitani R, Wilson R, Rutman A,.et al. Effects of human neutrophil elastase and Pseudomonas aeruginosa proteinases on human respiratory epithelium.Am J Respir Cell Mol Biol. 1991 Jan;4(1):26-32.
16. King PT，Hutchinson P，Holmes PW，et al. Assessing immune function in adult bronchiectasis. Clin Exp Immunol. 2006 Jun;144(3):440-446.
17. Elborn JS, Johnston B, Allen F，et al. Inhaled steroids in patients with bronchiectasis.Respir Med. 1992 Mar;86(2):121-4.
18. Tsang KW, Ho PL, Lam WK,.et al. Inhaled fluticasone reduces sputum inflammatory indices in severe bronchiectasis.Am J Respir Crit Care Med. 1998 Sep;158(3):723-7.
19. Tsang KW, Tan KC, Ho PL, ，et al：Exhaled nitric oxide in bronchiectasis: the effects of inhaled corticosteroid therapy，Int J Tuberc Lung Dis. 2004 Nov;8(11):1301-7.
20. Tsang KW，Tan KC，Ho PL，et al. Inhaled fluticasone in bronchiectasis: a 12 month study.Thorax. 2005 Mar;60(3):239-43.
21. Chan SL, Chan-Yeung MM, Ooi GC, et al. Validation of the Hong Kong Chinese version of the St. George Respiratory Questionnaire in patients with bronchiectasis.Chest. 2002 Dec;122(6):2030-7.
22. Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P, Soler-Cataluna JJ.，et al.Inhaled steroids improve quality of life in patients with steady-state bronchiectasis.Respir Med. 2006 Sep;100(9):1623-32. Epub 2006 Jan 24.
23. Lundgren JD, Shelhamer JH.. Pathogenesis of airway mucus hypersecretion.J Allergy Clin Immunol. 1990 Feb;85(2):399-417.
24. Kharitonov SA, Wells AU, O’Connor BJ，et al. Elevated levels of exhaled nitric oxide in bronchiectasis. Am J Respir Crit Care Med. 1995 Jun;151(6):1889-93.
25. Byrnes CA, Dinarevic S, Shinebourne EA.，et al. Exhaled nitric oxide measurements in normal and asthmatic children.Pediatr Pulmonol. 1997 Nov;24(5):312-8.
26. Baraldi E, Azzolin NM, Zanconato S, et al. Corticosteroids decrease exhaled nitric oxide in children with acute asthma. J Pediatr. 1997 Sep;131(3):381-5.
27. Kharitonov SA, Yates DH, Barnes PJ. Inhaled glucocorticoids decrease nitric oxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med. 1996 Jan;153(1):454-7..
28. Tsang KW, Lam SK, Lam WK，et al. High seroprevalence of Helicobacter pylori in active bronchiectasis.Am J Respir Crit Care Med. 1998 Oct;158(4):1047-51.

Chinese Journal of Respiratory and Critical Care Medicine

吸入激素在支氣管擴張癥中的應用

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