長效型氣管擴張劑之氣管擴張及抗發炎效果

10.6666/ClinMed.201804_81(4).0037

蕭逸函

慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD) ； 長效乙二型交感神經興奮劑(long acting β2-adrenergic receptor agonist, LABA) ； 長效抗膽鹼製劑(long acting muscarinic antagonist, LAMA) ； 氣道發炎(airway inflammation)

臨床醫學月刊

81卷4期（2018 / 04 / 27）

214 - 219

繁體中文

慢性阻塞性肺病的主因是長期吸菸導致氣道的發炎與重塑，造成支氣管收縮、呼吸氣流障礙等結果。因此，除了擴張支氣管以緩解症狀、延緩肺功能惡化之外，降低氣道發炎與重塑也是另一個重點。長效乙二型交感神經興奮劑及長效抗膽鹼製劑兩種氣管擴張劑是目前主要氣管擴張劑，但是在抗發炎部分，類固醇、第四型磷酸二酯酵素抑制劑、巨環內酯等藥物仍有阻抗性或副作用等缺點，亦無法阻止氣道重塑。近年的研究發現，長效乙二型交感神經興奮劑及長效抗膽鹼製劑除了擴張氣管之外，在細胞與小鼠動物實驗中，均顯示有對抗氣道發炎與重塑的效果。在臨床病人上，希望能透過選擇適當分型的患者或生物指標等方法取得更有力的證據。

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