Tlhahlobo ea meta e phatlalalitsoeng ho Internal Medicine e bonts'a hore lithibela-mafu le systemic glucocorticoids li amahanngoa le liphoso tse fokolang tsa kalafo ho batho ba baholo ba nang le lefu la tsoekere.COPDho mpefala ha ho bapisoa le placebo kapa ho se na thuso ea kalafo.

E le ho etsa tlhahlobo e hlophisitsoeng le tlhahlobo ea meta, Claudia C. Dobler, MD, Univesithi ea Bond, Australia, le ba bang ba ile ba hlahloba liteko tsa 68 tse laoloang ka nako e sa lekanyetsoang, ho akarelletsa le bakuli ba baholo ba 10,758 ba nang le ho eketseha ho hoholo ha maikutlo.COPDba ileng ba phekoloa sepetlele kapa sepetleleng sa kantle.Phuputso e ile ea bapisa mekhoa ea phekolo ea meriana le placebo, tlhokomelo ea kamehla kapa mekhoa e meng ea phekolo ea meriana.

Melemo ea lithibela-mafu le systemic glucocorticoids

Phuputsong e bapisoang ea matsatsi a 7-10 a lithibela-mafu tsa tsamaiso le placebo kapa tlhokomelo e tloaelehileng bakeng sa bakuli ba kulang kapa ba ka ntle, qetellong ea phekolo, lithibela-mafu li amana le ho phokotsa ho mpefala ha lefu lena, empa ha ho letho le amanang le lefu lena. ho tiea ha ho mpefala le tikoloho ea phekolo (OR = 2.03; 95% CI, 1.47- -2.8; boleng bo itekanetseng ba bopaki).Kamora ho fela ha ts'ebetso ea kalafo, thutong ea bakuli ba ka ntle ba nang le litlamorao tse mpe, kalafo ea lithibela-mafu e ka fokotsa sekhahla sa ho hloleha ha kalafo (OR = 0.54; 95% CI, 0.34-0.86; matla a lekaneng a bopaki).Bakuli ba ka hare le bakuli ba ka ntle ba nang le bothata bo fokolang ho isa ho bo itekanetseng kapa bo itekanetseng ho isa ho matla, lithibela-mafu le tsona li ka fokotsa bothata ba ho hema, ho khohlela le matšoao a mang.

Ka mokhoa o ts'oanang, bakeng sa bakuli le bakuli ba ka ntle, systemic glucocorticoids e bapisoa le placebo kapa tlhokomelo e tloaelehileng.Ka mor'a matsatsi a 9-56 a phekolo, li-glucocorticoids tsa tsamaiso ha li na monyetla oa ho hlōleha (OR = 0.01; 95% CI, 0- 0.13; boleng ba bopaki bo tlaase), ho sa tsotellehe tikoloho ea phekolo kapa tekanyo ea ho mpefala ho matla.Qetellong ea matsatsi a 7-9 a phekolo, bakuli ba nang le bothata bo fokolang ho isa boemong bo matla ba tleliniking ea bakuli ba sepetlele ba ile ba imoloha.Leha ho le joalo, li-glucocorticoids tsa tsamaiso li amahanngoa le keketseho ea palo ea liketsahalo tse mpe tse amanang le endocrine kaofela.

Bafuputsi ba lumela hore ho latela liphuputso tsa bona, lingaka le basebetsi-'moho le bona ba lokela ho tiisetsoa hore lithibela-mafu le systemic glucocorticoids li lokela ho sebelisoa ho mpefatsa boemo leha e le bofe bo matla.COPD(leha e le bonolo).Nakong e tlang, ba ka khona ho tseba hantle hore na ke bakuli bafe ba tla rua molemo ka ho fetisisa ho tsoa liphekolong tsena le hore na bakuli ba ka 'na ba se ke ba rua molemo ofe (ho itšetlehile ka li-biomarker, ho akarelletsa le protheine ea C-reactive kapa procalcitonin, eosinophils ea mali).

U hloka bopaki bo bongata

Ho ea ka bafuputsi, ho na le khaello ea boitsebiso bo tiileng mabapi le khetho ea lithibela-mafu kapa phekolo ea glucocorticoid, le bopaki ba tšebeliso ea meriana e meng, ho akarelletsa le aminophylline, magnesium sulfate, lithethefatsi tse thibelang ho ruruha, corticosteroids e inhaled, le bronchodilator e sebetsang nakoana.

Mofuputsi o itse o tla nyahamisa lingaka ho sebelisa liphekolo tse sa netefatsoang, tse kang aminophylline le magnesium sulfate.Bafuputsi ba lumela hore le hoja ho na le lithuto tse ngata ka COPD, lithethefatsi tse ngata bakeng sa ho phekola ho mpefala ha COPD ha li na bopaki bo lekaneng.Mohlala, ts'ebetsong ea bongaka, re tloaetse ho sebelisa li-bronchodilator tse nkang nako e khuts'oane ho imolla dyspnea nakong ea ho mpefala ha COPD.Tsena li kenyelletsa bahanyetsi ba nakoana ba muscarinic receptor (ipratropium bromide) le li-agonists tsa nakoana tsa beta (salbutamol).

Ntle le lipatlisiso tsa boleng bo holimo, lipatlisiso tse tšepahalang mabapi le kalafo ea lithethefatsi, bafuputsi ba boetse ba bonts'a hore mefuta e meng ea ho kenella le eona e ka ba ea bohlokoa ho ithutoa.

"Bopaki bo ntseng bo eketseha bo fana ka maikutlo a hore liphekolo tse ling tseo e seng tsa meriana, haholo-holo tse qalang ho ikoetlisa pele ho nako e ntseng e mpefala, li ka ntlafatsa ho mpefala ha bakuli ba COPD sepetlele.The American Thoracic Society / European Respiratory Conference ka 2017 Litaelo tse fanoeng li kenyelletsa likhothaletso tse nang le maemo (boleng bo tlaase haholo ba bopaki) nakong ea ho kena sepetlele ka ho mpefala ha COPD, u se ke ua qala ho tsosolosoa ha matšoafo, empa bopaki bo bong bo bocha bo hlahile ho tloha ka nako eo hore re hloka bopaki bo bongata ba boleng bo holimo ba boikoetliso ba pele nakong ea ho mpefala ha COPD ho netefatsa katleho ea boikoetliso ba pele bakeng sa ho mpefala ho hoholo ha COPD.