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Kronik obstrüktif akciğer hastalığında yeni gelişmeler

New developments in chronic obstructive pulmonary disease

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Abstract (2. Language): 
Chronic obstructive pulmonary disease is a major public health problem caused by long-term exposure to toxic gases and particules. Recent publications continue to use the basic criterion of FEV1/FVC <70% in defining the bronchial obstruction in guidelines of the Global Inintiative for Chronic Obstructive Lung Disease (GOLD). Unfortunately, using this fixed ratio in the diagnosis of chronic obstructive pulmonary disease may lead to misdiagnosis in the elderly since FEV1/FVC ratio declines with age. There is an increase in the frequency and nature of comorbidities such as coronary artery disease, hypertention, diabetes, pulmonary infections and cancer in patients with chronic obstructive pulmonary disease. Prevention of disease progression, improvement of symptoms, exercise tolerance, health status, and decrease in exacerbations and mortality are the main goals in the management of chronic obstructive pulmonary disease. Several novel bronchodilators are now in different stages of development for use alone or in combination with other agents.
Abstract (Original Language): 
Kronik obstrüktif akciğer hastalığı, uzun süre toksik gaz ve partiküllere maruziyetle oluşan önemli bir halk sağlığı sorunudur. Son yayınlar tanıda ‘Kronik Obstrüktif Akciğer Hastalığına Karşı Küresel Girişim’ (GOLD) rehberinde bronşiyal obstrüksiyon için belirlenen FEV1/FVC oranının %70’den küçük olması temel kriterini kullanmaya devam etmektedir. Ne yazık ki, FEV1/FVC oranı yaşla beraber düştüğü için, bu sabit oranın kronik obstrüktif akciğer hastalığı tanısında kullanılması yaşlı popülasyonda yanlış kronik obstrüktif akciğer hastalığı tanısına yol açabilir. Kronik obstrüktif akciğer hastalıklı hastalarda, koroner arter hastalığı, hipertansiyon, diyabet, akciğer enfeksiyonları ve kanser gibi eşlik eden hastalıkların çeşit ve sıklığında artış bulunmaktadır. Kronik obstrüktif akciğer hastalığının tedavisinde temel hedefler, hastalığın progresyonunu önlemeye, semptomları, egzersiz toleransı, genel sağlık durumunu düzeltmeye ve ataklar ile mortaliteyi azaltmaya yöneliktir. Halihazırda, bazı yeni bronkodilatörler, tek başına veya diğer ilaçlarla kombine olarak kullanım yönünden değişik araştırma aşamalarındadır.
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