支氣管擴(kuò)張癥(簡(jiǎn)稱支擴(kuò))是指由多種原因引起支氣管壁肌肉和彈力支撐組織的破壞而引起的中等大小支氣管的不正常擴(kuò)張，是一種肺組織結(jié)構(gòu)破壞性疾病，表現(xiàn)為反復(fù)呼吸道感染，大量膿痰，可出現(xiàn)咯血。支擴(kuò)有許多相關(guān)因素及病因，總體來(lái)說(shuō)，其發(fā)生可歸結(jié)于以下兩個(gè)因素：① 感染的持續(xù)刺激；②氣道阻塞、支氣管引流功能損害和防御功能的缺陷。兩種因素可以同時(shí)存在，互為因果。支擴(kuò)的病程一般呈進(jìn)行性發(fā)展，其機(jī)制可用Cole[1] 在1984年提出的惡性循環(huán)(vicious circle)假說(shuō)來(lái)解釋，該假說(shuō)認(rèn)為感染或定植的細(xì)菌觸發(fā)氣道上皮的炎癥反應(yīng)，釋放炎癥介質(zhì)和酶，持續(xù)的慢性炎癥反應(yīng)引起支氣管壁和肺組織的損傷，破壞氣道纖毛上皮的清潔功能，進(jìn)一步加重感染和細(xì)菌定植，形成一個(gè)周而復(fù)始的惡性循環(huán)。因此，抗生素幾乎是現(xiàn)階段治療支擴(kuò)的主要藥物之一。
引用本文： 朱硯萍,瞿介明. 支氣管擴(kuò)張癥的抗生素治療. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2007, 6(3): 161-162. doi: 復(fù)制
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| 4. | O’Donnell AE, Barker AF, Ilowite JS, et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. rhDNase Study Group.Chest，1998，113：1329-1334. |
| 5. | Bilton D, Henig N, Morrissey B, et al. Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis. Chest, 2006;130:1503-1510. |
| 6. | Wallace RJ，Glassroth J，Griffith DE，et al.Diagnosi and treatment of disease caused by nontuberculous mycobacteria.Am J Respir Crit Care Med，1997，156(Suppl)：1-25. |
| 7. | Stevens DA，Schwartz HJ，Lee JY，et al. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis.N Engl J Med，2000，342：756-762. |
| 8. | Tsang KW，Ho PI，Chan KN，et al. A pilot study of low-dose erythromycin in bronchiectasis.Eur Respir J. 1999;13:361-364. |
| 9. | Rayner CF，Tillotson G，Cole PJ，et al. Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis. J Antimicrob Chemother. 1994 Jul;34(1):149-56.. |
| 10. | Stockley RA, Hill SL, Morrison HM. Effect of antibiotic treatment on sputum elastase in bronchiectatic outpatients in a stable clinical state.Thorax. 1984 Jun;39(6):414-9. |
| 11. | Hill SL，Burnett D，Hewetson KA，et al. The response of patients with purulent bronchiectasis to antibiotics for four months. Q J Med,1988;66:163-73. |
- 1. Cole PJ.A new look at the pathogenesis，management of persistent bronchial sepsis：a ‘vicious circle’hypothesis and its logical therapeutic connotations.In：Davies RJ，editor.Strategies for the management of chronic bronchial sepsis.Oxford：Medicine Publishing Foundation，1984，1-20.
- 2. Barker AF. Bronchiectasis.N Engl J Med，2002，346.：1383-1393.
- 3. Pasteur MC, Helliwell SM, Houghton SJ,et al. An investigation into causative factors in patients with bronchiectasis .Am J Respir Crit Care Med，2000，162：1277-1284.
- 4. O’Donnell AE, Barker AF, Ilowite JS, et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. rhDNase Study Group.Chest，1998，113：1329-1334.
- 5. Bilton D, Henig N, Morrissey B, et al. Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis. Chest, 2006;130:1503-1510.
- 6. Wallace RJ，Glassroth J，Griffith DE，et al.Diagnosi and treatment of disease caused by nontuberculous mycobacteria.Am J Respir Crit Care Med，1997，156(Suppl)：1-25.
- 7. Stevens DA，Schwartz HJ，Lee JY，et al. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis.N Engl J Med，2000，342：756-762.
- 8. Tsang KW，Ho PI，Chan KN，et al. A pilot study of low-dose erythromycin in bronchiectasis.Eur Respir J. 1999;13:361-364.
- 9. Rayner CF，Tillotson G，Cole PJ，et al. Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis. J Antimicrob Chemother. 1994 Jul;34(1):149-56..
- 10. Stockley RA, Hill SL, Morrison HM. Effect of antibiotic treatment on sputum elastase in bronchiectatic outpatients in a stable clinical state.Thorax. 1984 Jun;39(6):414-9.
- 11. Hill SL，Burnett D，Hewetson KA，et al. The response of patients with purulent bronchiectasis to antibiotics for four months. Q J Med,1988;66:163-73.