Non-CF-Bronchiektasen: Diagnostik und Therapie

Zusammenfassung

Bronchiektasen bezeichnen irreversibel erweiterte Atemwege. Genaue epidemiologische Angaben zur Prävalenz von Bronchiektasen existieren nicht, sie sind aber häufig und werden zunehmend als solche erkannt. Eine Vielzahl von Erkrankungen und Auslöser können zu Bronchiektasen führen, häufig bleibt ihre Ätiologie unklar. Eine chronische pulmonale Infektion mit Pseudomonas aeruginosa ist mit einem schwereren klinischen Verlauf assoziiert und beeinflusst das therapeutische Management. Physiotherapie, mukoaktive Substanzen und Antibiotika sind die Eckpfeiler der Therapie von Bronchiektasen. Einen zunehmenden Stellenwert hat die immunmodulatorische Therapie mit Makroliden. In dieser Übersicht werden notwendige Abklärungen und neueste Entwicklungen hinsichtlich therapeutischer Ansätze bei Non-CF-Bronchiektasen diskutiert.

Abstract

Bronchiectasis is the term used for irreversibly dilated airways. Exact epidemiological information on the frequency of bronchiectasis is not available, but the morphological findings are increasingly detected and the associated syndrome is more frequently diagnosed due to improved imaging techniques and increased awareness among chest physicians. The workup of these patients includes a wide panel of investigations guided by patient history and clinical presentation. Despite thorough evaluation the aetiology frequently remains unclear. Chronic infection with Pseudomonas aeruginosa is associated with a severe course of the disease and its detection has impacts on the therapeutic management. Chest physiotherapy, mucoactive substances and antibiotics are the mainstay of therapy. In this review the evaluation of bronchiectasis and the recent therapeutic insights for non-cystic fibrosis bronchiectasis are discussed.

Schlüsselwörter

Non-CF Bronchiektasen - Abklärung - Keimspektrum - Exazerbationen - Therapie

Keywords

non-CF bronchiectasis - diagnosis - bacteria - exacerbation - therapy

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