The role of corticosteroids in chronic obstructive pulmonary disease.

摘要: Oral corticosteroids are powerful relatively nonspecific antiinflammatory agents with a range of well-characterized side effects. There is good evidence to show that they accelerate the rate resolution exacerbations COPD and relapse less likely if patients receive these drugs. Maintenance therapy oral preparations associated worse mortality skeletal muscle myopathy particular problem. Corticosteroids have little effect on biopsy proven inflammation or its surrogates in did not change decline FEV (1) over spirometric disease severity number trials each lasting 3 years. However, meta-analysis data suggests small (up 10 ml /year) might be present. more consistent for an postbronchodilator both fluticasone propionate budesonide. In < 50% predicted where self-reported become common, inhaled can reduce attacks. This major factor accounting reduction deterioration health status seen who corticosteroids. Inhaled much safer than therapy, although do predictably higher incidence candidiasis hoarseness voice. Skin bruising better lung function use Triamcinolone bone density but this was Combining corticosteroid long-acting beta-agonist same inhaler increases efficacy latte drug patients, significantly larger improvement (1), reported breathlessness, exacerbation numbers those severe beta-agonists appear effective. suitable monotherapy helpfully combined bronchodilator symptomatic disease.