• 제목/요약/키워드: Chronic obstructive pulmonary disease (COPD)

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천식환자 및 만성 폐쇄성 폐질환환자군에서 연간 최대 호기유속의 변화량 (Annual Change of Peak Expiratory Flow Rate in Asthma and COPD)

  • 홍성철;이초이;한장수;김원동;이계영;김순종;김희정;하경원;전규락;유광하
    • Tuberculosis and Respiratory Diseases
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    • 제72권1호
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    • pp.24-29
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    • 2012
  • Background: Measurement of peak expiratory flow rate (PEFR) in a follow-up examination for a chronic airway disease is useful because it has the advantages of being a simple measurement and can be repeated during examination. The aim of this study was to examine the annual decrease of PEFR in asthma and chronic obstructive pulmonary disease (COPD) patients and to confirm the factors which influence this decrease. Methods: From May, 2003 to September, 2010, the annual decrease of PEFR was obtained from asthma and COPD patients attending an outpatient pulmonary clinic. PEFR was measured using a Mini-Wright peak flow meter (Clement Clarke International Ltd. UK), and we conducted an analysis of factors that influence the change of PEFR and its average values. Results: The results showed an annual decrease of $1.70{\pm}12.86$ L/min the asthmatic patients and an annual decrease of $10.3{\pm}7.32$ L/min in the COPD patients. Age and $FEV_1$ were the predictive factors influencing change in asthma, and $FEV_1$ and smoking were the predictive factors influencing change in COPD. Conclusion: We confirmed the annual decreasing PEFR in patients with chronic airway disease and identified factors that work in conjunction with $FEV_1$ to influence the change.

만성 폐쇄성 폐질환 환자에서 Tei 지수를 이용한 우심실기능 평가 (Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index)

  • 오윤정;신준한;김덕기;최영화;박광주;황성철;이이형
    • Tuberculosis and Respiratory Diseases
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    • 제50권3호
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    • pp.343-352
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    • 2001
  • 연구배경 : 만성 폐쇄성 폐질환 기능의 평가를 위해서 여러 가지 비침습적, 침습적 방법이 이용되나 그 정확도나 실용성에 있어서 한계가 있었다. 최근 도플러 심초음파상의 수축기, 이완기 및 박출시간을 조합한 기능지수인 Tei 지수가 우심실기능을 평가하는 유용한 방법으로 알려지고 있어 저자 등은 만성 폐쇄성 폐질환 환자의 Tei 지수를 구하여 우심실 기능을 평가하고 폐기능검사와의 상관관계를 알아보고자 하였다. 대상 및 방법 : 만성 폐쇄성 폐질환 환자 26예와 대조군 10예을 대상으로 간헐파 도플러를 이용하여 도플러 간격을 측정하였다. Tei 지수는 등용성 수축시간(ICT)과 등용성 이완시간(IRT)의 합을 박출시간(ET)으로 나누어 구하였고, PEP, ICT/ET, PEP/ET, IRT/ET를 측정하여 환자군과 대조군을 비교하였다. 폐기능과 Tei 지수의 상관관계를 구하였고, Tei 지수와 다른 도플러 간격의 상관관계를 알아보았다. 결 과 : Tei 지수는 환자군에서 대조군에 비해 유의하게 증가되어 있었고($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01), ICT/ET ($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), PEP/ET ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05), IRT/ET ($0.29{\pm}0.16$ vs. $0.15{\pm}0.15$, p&0.05) 등은 대조군보다 증가되어 있었으며 박출시간은 단축되어있었다($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$, p<0.05). 환자군에서 Tei 지수는 1초간 노력성 호기량과 역상관성을 보였고 (r=-0.469), 중증 폐기능 장애가 있는 3기 환자는 1기나 2기 환자에 비해 Tei 지수가 증가되어 있었다. 환자군에서 Tei 지수는 박출시간과 역상관성을 보였고 (r=-0.469), ICT/ET(r=0.453), PEP/ET(r=0.480), IRT(r=0.812), IRT/ET(r=0.896) 는 Tei 지수와 유의한 상관관계가 있었다. 결 론 : Tei 지수는 만성 폐쇄성 폐질환 환자에서 정상 대조군에 비해 유의하게 증가되어 있으며 폐기능 지표와도 유의한 연관성을 보여 만성 폐쇄성 폐질환 환자의 우심실 기능을 평가하는데 유용한 검사법으로 사료된다.

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Recent Advances in the Development of Novel Drug Candidates for Regulating the Secretion of Pulmonary Mucus

  • Li, Xin;Jin, Fengri;Lee, Hyun Jae;Lee, Choong Jae
    • Biomolecules & Therapeutics
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    • 제28권4호
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    • pp.293-301
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    • 2020
  • Hypersecretion of pulmonary mucus is a major pathophysiological feature in allergic and inflammatory respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). Overproduction and/or oversecretion of mucus cause the airway obstruction and the colonization of pathogenic microbes. Developing a novel pharmacological agent to regulate the production and/or secretion of pulmonary mucus can be a useful strategy for the effective management of pathologic hypersecretion of mucus observed in COPD and asthma. Thus, in the present review, we tried to give an overview of the conventional pharmacotherapy for mucus-hypersecretory diseases and recent research results on searching for the novel candidate agents for controlling of pulmonary mucus hypersecretion, aiming to shed light on the potential efficacious pharmacotherapy of mucus-hypersecretory diseases.

한방병원 외래에 내원한 COPD환자 대한 후향적 임상 분석 (A Retrospective Clinical Analysis of Chronic Obstructive Pulmonary Disease (COPD) Outpatients Who Presented To a Korean Medicine Hospital: Symptoms and Treatment Effects)

  • 백현정;방연희;김재효;김상진;김관일;이범준;정희재;정승기
    • 대한한방내과학회지
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    • 제37권4호
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    • pp.624-630
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    • 2016
  • Objective: This study was designed to analyze the symptoms of chronic obstructive pulmonary disease (COPD) patients who attended a Korean medicine hospital and treatment effects through retrospective chart reviews.Methods: The medical records of 192 outpatients who had been diagnosed with COPD and visited the Allergy, Immune, and Respiratory System Department of Kyung Hee Korean Medicine Hospital from 1 February 2006 to 1 February, 2016 were retrospectively reviewed.Results: The study group consisted of 112 and 80 females. The median age of the patients was 59.80±15.46 y. Fifty of the patients had been diagnosed with chronic upper respiratory diseases, such as chronic rhinitis, nasopharyngitis, or sinusitis. The chief complaints were cough (n=136), sputum (n=124), and dyspnea (n=82). Other frequent symptoms were fatigue (n=11), hyperhidrosis (n=8), and a bad taste in the mouth (n=7). All the patients were prescribed Korean herbal medicine. In the study, 61 (31.77%) patients were treated with acupuncture, moxibustion, cupping therapy, or herbal steam therapy. Symptoms improved in 126 (65.63%) patients 141±272.82 d after the first treatment.Conclusions: Some of the COPD patients had chronic upper respiratory disease. The chief complains were cough, sputum, and dyspnea. Oher frequent symptoms related to body malfunction and pain. The symptoms improved in 126 (65.63%) patients 141.00±272.82 d post-treatment.

Exhaled Nitric Oxide in Patients with Stable Chronic Obstructive Pulmonary Disease: Clinical Implications of the Use of Inhaled Corticosteroids

  • Jo, Yong Suk;Choe, Junsu;Shin, Sun Hye;Koo, Hyeon-Kyoung;Lee, Won-Yeon;Kim, Yu Il;Ra, Seung Won;Yoo, Kwang Ha;Jung, Ki Suck;Park, Hye Yun;Park, Yong-Bum
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.42-50
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    • 2020
  • Background: Fractional exhaled nitric oxide (FeNO) is regarded as a potential biomarker for identifying eosinophilic inflammation. We aimed to evaluate the clinical implication of FeNO and its influence on inhaled corticosteroids (ICS) prescription rate in Korean chronic obstructive pulmonary disease (COPD) patients. Methods: FeNO level and its association with clinical features were analyzed. Changes in the prescription rate of ICS before and after FeNO measurement were identified. Results: A total of 160 COPD patients were divided into increased (≥25 parts per billion [ppb], n=74) and normal (<25 ppb, n=86) FeNO groups according to the recommendations from the American Thoracic Society. Compared with the normal FeNO group, the adjusted odds ratio for having history of asthma without wheezing and with wheezing in the increased FeNO group were 2.96 (95% confidence interval [CI], 1.40-6.29) and 4.24 (95% CI, 1.37-13.08), respectively. Only 21 out of 74 patients (28.4%) with increased FeNO prescribed ICS-containing inhaler and 18 of 86 patients (20.9%) with normal FeNO were given ICS-containing inhaler. Previous exacerbation, asthma, and wheezing were the major factors to maintain ICS at normal FeNO level and not to initiate ICS at increased FeNO level. Conclusion: Increased FeNO was associated with the history of asthma irrespective of wheezing. However, FeNO seemed to play a subsidiary role in the use of ICS-containing inhalers in real-world clinics, which was determined with prior exacerbation and clinical features suggesting Th2 inflammation.

만성 폐쇄성 폐질환자의 질병관련 지식, 질병태도, 삶의 질에 관한 연구 (Relationship of Knowledge about Disease, Illness Attitude, and Quality of Life for Patients with Chronic Obstructive Pulmonary Disease(COPD))

  • 방윤이;박효정
    • 한국콘텐츠학회논문지
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    • 제17권11호
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    • pp.410-422
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    • 2017
  • 본 연구의 목적은 만성 폐쇄성 폐질환자(COPD)의 질병관련 지식, 질병태도, 삶의 질 세요인간의 상관관계를 규명하고자 시도되었다. 연구결과 질병관련 지식은 대상자의 교육과 월수입, 주관적 호흡곤란 정도(mMRC), 흡입형 기관지 확장제, 항생제 치료에 따라 유의한 차이가 있었고 질병태도는 월수입, mMRC에 따라 유의한 차이가 있었다. 또한 삶의 질은 연령, 결혼상태, 월수입, 입원상태, 입원경험, 산소사용, 동반질환, mMRC, 흡입형 스테로이드에 따라 유의한 차이가 있었다. 질병관련 지식과 삶의 질(r=-.438, p<.001), 질병태도와 삶의 질(r=.279, p=.001)은 유의한 상관관계가 있는 것으로 나타났다. 따라서 세 요인에 공통적으로 상관성을 보인 변수인 월수입과 mMRC를 파악하는 것이 중요하며, 임상에서 COPD환자의 상태평가시, 객관적 검사결과 뿐만 아니라 mMRC의 사정에 관심을 가지고, 저소득계층을 중심으로 질병관련 지식향상과 긍정적인 태도함량을 위한 다학제간 접근과, 헬스코칭 프로그램을 개발하는 것이 필요하다.

만성폐쇄성폐질환에 폐렴과 급성악화로 입원한 환자의 임상적 특성 및 예후 비교 (Comparisons of Clinical Characteristics and Outcomes in COPD Patients Hospitalized with Community-acquired Pneumonia and Acute Exacerbation)

  • 정승욱;이재희;최금주;황보엽;김이영;이윤지;윤원경;김민;차승익;박재용;정태훈;김창호
    • Tuberculosis and Respiratory Diseases
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    • 제69권1호
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    • pp.31-38
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    • 2010
  • Background: Data comparing the clinical characteristics and outcomes in chronic obstructive pulmonary disease (COPD) patients hospitalized with community-acquired pneumonia (CAP-COPD) and acute exacerbation (AECOPD) are very limited. Methods: Eighty episodes of hospitalization in 65 CAP-COPD patients, and 111 episodes of hospitalization in 82 AE-COPD patients were included in this study. The baseline characteristics, clinical presentations, potential bacterial pathogens and clinical outcomes in these patients were retrospectively reviewed and compared. Results: No significant differences were found between the two groups in parameters related to COPD and co-morbidities, except a higher rate of male among CAP-COPD patients. Clinical presentations by symptoms and laboratory findings on admission were significantly more severe in CAP-COPD patients, who showed higher rates of fever and crepitation, but less wheezing than AE-COPD patients. S. pneumoniae and P. aeruginosae were the most common bacterial pathogens in both groups. With no difference in the overall hospital mortality between both groups, the mean length of hospital stay was significantly longer in the CAP-COPD patients than in AE-COPD patients (15.3 vs. 9.8 days, respectively, p<0.01). Additional analysis on CAP-COPD patients showed that systemic steroid use did not influence the length of hospital stay. Conclusion: Although there was no significant difference in bacterial pathogens and overall hospital mortality between the two groups, CAP-COPD patients had more severe clinical symptoms and laboratory findings at presentation, and longer hospital stay than AE-COPD patients.

맥문동이 LPS로 유도된 폐손상에 미치는 영향 (Effects of Root of Liriope Spicata on LPS-induced Lung Injury)

  • 이응석;양수영;김민희;남궁욱;박양춘
    • 동의생리병리학회지
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    • 제25권4호
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    • pp.641-649
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    • 2011
  • This study was purposed to evaluate the effects of root of Liriope spicata (RLS) on LPS-induced COPD (chronic obstructive pulmonary disease) model. The extract of RLS was treated to A549 cells and LPS-induced COPD mice model. Then, various parameters such as cell-based cyto-protective activity and histopathological finding were analyzed. RLS showed a protective effect on LPS-induced cytotoxicity in A549 cells. This effect was correlated with analysis for caspase 3 levels, protein level of cyclin B1, Cdc2, and phospho-Erk1/2, and gene expression of TNF-${\alpha}$ and IL-$1{\beta}$ in A549 cells. RLS treatment also revealed the protective effect on LPS-induced lung injury in COPD mice model. This effect was evidenced via histopathological finding including immunofluence stains against caspase 3, and protein level of cyclin B1, Cdc2, and Erk1/2 in lung tissue. These data suggest that RLS has a pharmaceutical properties on lung injury. This study would provide an scientific evidence for the efficacy of RLS for clinical application to patients with COPD.

폐쇄성폐질환에서 우울증상의 빈도 및 위험 인자 (Prevalence and Risk Factors of Depression in Patients with Chronic Obstructive Pulmonary Disease)

  • 진현정;이관호;박찬서;손창우;이하영;유성근;신경철;정진홍;김정엽
    • Tuberculosis and Respiratory Diseases
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    • 제65권3호
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    • pp.191-197
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    • 2008
  • 연구배경: 만성폐쇄성폐질환에서 점진적인 폐기능의 악화 및 치료의 장기화는 환자의 삶의 질을 저하시키며 우울증의 발생 가능성을 높인다. 만성폐쇄성폐질환에서 우울증의 빈도, 호흡기 증상과 관련된 삶의 질 정도와 우울증과의 관계 및 관련 인자에 관해 알아보았다. 방 법: 대상은 2007년 3월부터 9월까지 영남대학교 의료원 호흡기내과 외래를 방문한 59명의 만성폐쇄성폐질환환자로 하였으며, 이들에서 폐기능 검사 및 해당 설문조사를 시행하였다. 호흡기 증상과 관련된 삶의 질에 대한 평가는 SGRQ (St. George's Respiratory Questionnaire), 우울증은 우울척도인 CES-D (Center for Epidermiological Studies-Depression Scale)를 사용하였다. 결 과: 연구 결과 만성폐쇄성폐질환자에서 우울증의 유병율은 17.0%로 일반인들의 우울증 유병률보다 높았다.SGRQ 결과 증상, 활동 제한, 영향력 제한, 총 점수 모두 우울증상과 양의 상관관계를 보였다(p=0.010, 0.001, 0.000, 0.046). 폐기능 검사에서 $FEV_1$은 SGRQ 및 우울증상과 음의상관관계를 보였다(p=0.001, 0.000, 0.000, 0.002, 0.006). 만성폐쇄성폐질환 환자에서 생활수준이 낮을수록 우울증상은 증가하였고 삶의 질도 저하되었으나 교육 수준, 신뢰도 정도 등과는 통계적으로 유의한 차이가 없었다. 결 론: 만성폐쇄성폐질환 환자는 일반인들에 비해 우울증의 유병률이 높았으며 우울증상에 관여하는 의미있는 인자는 폐기능의 감소와 경제적 수준이었다.

The role of FGF-2 in smoke-induced emphysema and the therapeutic potential of recombinant FGF-2 in patients with COPD

  • Kim, You-Sun;Hong, Goohyeon;Kim, Doh Hyung;Kim, Young Min;Kim, Yoon-Keun;Oh, Yeon-Mok;Jee, Young-Koo
    • Experimental and Molecular Medicine
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    • 제50권11호
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    • pp.9.1-9.10
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    • 2018
  • Although the positive effects of recombinant fibroblast growth factor-2 (rFGF-2) in chronic obstructive pulmonary disease (COPD) have been implicated in previous studies, knowledge of its role in COPD remains limited. The mechanism of FGF2 in a COPD mouse model and the therapeutic potential of rFGF-2 were investigated in COPD. The mechanism and protective effects of rFGF-2 were evaluated in cigarette smoke-exposed or elastase-induced COPD animal models. Inflammation was assessed in alveolar cells and lung tissues from mice. FGF-2 was decreased in the lungs of cigarette smoke-exposed mice. Intranasal use of rFGF-2 significantly reduced macrophage-dominant inflammation and alveolar destruction in the lungs. In the elastase-induced emphysema model, rFGF-2 improved regeneration of the lungs. In humans, plasma FGF-2 was decreased significantly in COPD compared with normal subjects (10 subjects, P = 0.037). The safety and efficacy of inhaled rFGF-2 use was examined in COPD patients, along with changes in respiratory symptoms and pulmonary function. A 2-week treatment with inhaled rFGF-2 in COPD (n = 6) resulted in significantly improved respiratory symptoms compared with baseline levels (P < 0.05); however, the results were not significant compared with the placebo. The pulmonary function test results of COPD improved numerically compared with those in the placebo, but the difference was not statistically significant. No serious adverse events occurred during treatment with inhaled rFGF-2. The loss of FGF-2 production is an important mechanism in the development of COPD. Inhaling rFGF-2 may be a new therapeutic option for patients with COPD because rFGF-2 decreases inflammation in lungs exposed to cigarette smoke.