支氣管擴張症及其治療之文獻回顧

Pharmacotherapy of Bronchiectasis: A Literature Review

楊璦瑜(Ai-Yu Yang) ； 蘇玉惠(Yu-Hui Su) ； 郭震羣(Chen-Chun Kuo)

《臺灣臨床藥學雜誌》 25卷4期 (2017/10) Pp. 288-296

https://doi.org/10.6168/FJCP.2017.2504.03

摘要

支氣管擴張症(bronchiectasis)是一個慢性的肺部疾病，因反覆性的呼吸道感染及發炎導致支氣管永久性擴張，再者因慢性氣道感染及肺功能喪失而導致死亡率增加。其中非囊狀纖維化支氣管擴張症在亞洲族群的罹病率是最高的，流行率逐年攀升。目前文獻支持長期使用大環內酯類抗生素治療反覆急性發作的病人，可減少惡化頻率並具有抗發炎作用；吸入劑型的抗生素，則可降低疾病惡化、細菌發炎反應。使用抗生素結合氣道清除術、支氣管擴張劑、抗發炎藥物合併治療可改善病人的症狀及生活品質，進而保護肺部功能。本文將藉由文獻回顧，探討支氣管擴張症的致病機轉、藥物治療及藥事照護，以提升疾病治療的有效性與安全性。

關鍵字

支氣管擴張症 ； 大環內酯類抗生素 ； 抗生素治療

並列摘要

Bronchiectasis is a chronic lung disease characterized by permanent dilatation of bronchi, due to vicious cycle of transmural infection and inflammation. Bronchiectasis is associated with chronic and frequently purulent expectoration, multiple exacerbations, impaired lung function usually comprising to increase mortality. Non-cystic fibrosis bronchiectasis was highest in prevalence in Asian populations, the prevalence increased every year. The current literature supports the long-time use of macrolide therapy in bronchiectasis patients who have frequent exacerbations. It reduce exacerbation frequency and have anti-inflammatory therapy. Antibiotics in the inhalational form, reduce exacerbations and inflammation by decreasing bacterial density. Using antibiotic therapy should be incorporated into airway clearance, bronchodilation, anti-inflammatory treatment that will improve the disease symptoms and quality of life, preserve lung function. We discussed the pathogenesis, pharmacologic treatment and pharmaceutical care for bronchiectasis by literature review, hope to enhance efficacy and safety of disease treatment.

並列關鍵字

Bronchiectasis ； Macrolide Antibiotic ； Antibiotic Therapy