O se suʻesuʻega faʻataʻitaʻiga na lomia i totonu Faʻafomaʻi Totonu o loʻo faʻaalia ai o vailaʻau faʻamaʻi ma glucocorticoids faʻapitoa e fesoʻotaʻi ma le itiiti ifo o togafitiga faʻaletonu i tagata matutua maCOPDexacerbations fa'atusatusa ile placebo po'o le leai o se togafiti fa'afoma'i.

Ina ia mafai ona faʻatautaia se iloiloga faʻapitoa ma faʻataʻitaʻiga faʻataʻitaʻiga, Claudia C. Dobler, MD, Bond University, Ausetalia, ma isi na suʻesuʻeina 68 faʻataʻitaʻiga faʻataʻitaʻiina, e aofia ai ma le 10,758 tagata matutua maʻi ma faʻalavelave faʻalavelave oCOPDoe na togafitia ile falema'i po'o ma'i fafo.O le suʻesuʻega faʻatusatusa faʻalavelave faʻafomaʻi ma placebo, tausiga masani poʻo isi faʻalavelave faʻafomaʻi.

Fa'amanuiaga o vaila'au fa'ama'i ma fa'aogaina glucocorticoids

I se suʻesuʻega faʻatusatusa o le 7-10 aso o faʻamaʻi faʻamaʻi ma placebo poʻo le tausiga masani mo tagata maʻi poʻo maʻi i fafo, i le faaiuga o togafitiga, o vailaʻau faʻamaʻi e fesoʻotaʻi ma le faʻamagaloina o le faʻateleina o le faʻamaʻi, ae leai se mea e fai i le ogaoga o le faʻalavelave ma le siosiomaga togafitiga (OR = 2.03; 95% CI, 1.47- -2.8; tulaga lelei o faʻamaoniga).A maeʻa le faʻamutaina o togafitiga faʻapitoa, i le suʻesuʻeina o tagata mai fafo ma le faʻalavelave faʻafuaseʻi, faʻamaʻi faʻamaʻi faʻamaʻi e mafai ona faʻaitiitia ai le fua o le le manuia o togafitiga (OR = 0.54; 95% CI, 0.34-0.86; faʻamaoniga faʻamaonia malosi).O ma'i ile falema'i ma tagata i fafo o lo'o iai le fa'amama i le feololo po'o le feololo i le ogaoga o le fa'alavelave, o vaila'au fa'ama'i e mafai fo'i ona fa'aitiitia ai le manava manava, tale ma isi fa'ailoga.

E fa'apena fo'i, mo ma'i i totonu ma ma'i i fafo, e fa'atusaina le glucocorticoids fa'apitoa i le placebo po'o le tausiga masani.A maeʻa le 9-56 aso o togafitiga, o le glucocorticoids faʻapitoa e le mafai ona toilalo (OR = 0.01; 95% CI, 0- 0.13; le lelei o faʻamaoniga e maualalo), e tusa lava po o le a le siosiomaga togafitiga poʻo le tikeri o le faʻalavelave faʻafuaseʻi.I le faaiuga o le 7-9 aso o togafitiga, o tagata mamaʻi ma faʻalavelave faʻafuaseʻi i le falemaʻi i fafo ma le falemaʻi na faʻamaloloina o latou dyspnea.Ae ui i lea, o le glucocorticoids faʻapitoa e fesoʻotaʻi ma le faʻateleina o le aofaʻi o faʻalavelave faʻalavelave faʻafuaseʻi ma endocrine.

E talitonu tagata suʻesuʻe e faʻavae i luga oa latou suʻesuʻega, e tatau i fomaʻi ma paʻaga ona faʻamautinoa e tatau ona faʻaaogaina vailaau faʻamaʻi ma glucocorticoids i soʻo se faʻalavelave matuia oCOPD(tusa lava pe agamalu).I le lumanaʻi, atonu e mafai ona sili atu ona latou iloa poʻo fea tagata gasegase o le a sili atu ona manuia mai nei togafitiga ma e ono le manuia ai tagata gasegase (faʻavae i luga o biomarkers, e aofia ai le C-reactive protein poʻo le procalcitonin, toto eosinophils).

Manaomia nisi faʻamaoniga

E tusa ai ma le au suʻesuʻe, o loʻo i ai le le lava o faʻamatalaga faʻamaonia i luga o le fiafia i vailaau faʻamaʻi poʻo le glucocorticoid therapy, ma faʻamaoniga o le faʻaogaina o isi vailaʻau, e aofia ai aminophylline, magnesium sulfate, vailaʻau faʻamaʻi, corticosteroids inhaled, ma bronchodilators puʻupuʻu.

Fai mai le tagata suʻesuʻe o le a ia faʻavaivaia fomaʻi mai le faʻaaogaina o togafitiga e leʻi faʻamaonia, e pei o le aminophylline ma le magnesium sulfate.E talitonu tagata suʻesuʻe e ui lava e tele suʻesuʻega ile COPD, o le tele o vailaʻau mo le togafitia o faʻalavelave matuia o le COPD e le lava faʻamaoniga.Mo se faʻataʻitaʻiga, i faʻataʻitaʻiga falemaʻi, e masani ona matou faʻaogaina bronchodilators puʻupuʻu e faʻamalolo ai le dyspnea i le taimi o faʻalavelave faʻafuaseʻi o le COPD.O nei mea e aofia ai faʻalavelave faʻafuaseʻi muscarinic receptor antagonists (ipratropium bromide) ma agonists beta receptor agonists puʻupuʻu (salbutamol).

I le faʻaopoopoga i suʻesuʻega maualuga, suʻesuʻega faʻalagolago i togafitiga o vailaʻau, na faʻaalia foi e le au suʻesuʻe o isi ituaiga o faʻalavelave e ono aoga foi le suʻesuʻeina.

"O le tuputupu aʻe o faʻamaoniga e taʻu mai ai o nisi o togafitiga e le o ni vailaʻau, aemaise lava i latou e amata faʻamalositino vave i le faʻalavelave faʻalavelave, e mafai ona faʻaleleia le faʻaogaina i le ogaoga o faʻamaʻi o tagata COPD i le falemaʻi.Le American Thoracic Society/European Respiratory Conference i le 2017 O taʻiala tuʻuina atu e aofia ai fautuaga faʻapitoa (matua maualalo le lelei o faʻamaoniga) i le taimi o le falemaʻi o faʻalavelave faʻafuaseʻi o le COPD, aua le amataina le toe faʻaleleia o le pulmonary, ae o nisi faʻamaoniga fou ua aliaʻe talu mai lena taimi e manaʻomia se le tele o faʻamaoniga maualuga o le vave faʻamalositino i le taimi o le faʻalavelave faʻafuaseʻi o le COPD e faʻamaonia le aoga o le vave faʻamalositino mo le faʻalavelave faʻafuaseʻi o le COPD.