阿托品对等二氧化碳过度通气诱发支气管收缩的影响

Effect of atropine on bronchoconstriction induced by isocapnic hyper-ventilation in asthma

作者对12名缓解期支气管哮喘患者进行自身对比研究,观察雾化吸入硫酸阿托品对等二氧化碳过度通气试验(IHV)诱发支气管收缩的影响.吸入阿托品后FEV_1基础值由吸药前的2.82±0.62 L增加到3.37±0.68 L(P<0.01);IHV试验△FEV_1％值,未吸阿托品时为31.0±14.6,吸阿托品后为8.7±8.9(P<0.01).为了排除吸入阿托品后基础FEV_1变化的影响,采用协方差分析法进行检验.排除阿托品吸入后支气管扩张作用的影响,其对IHV诱发的支气管收缩有明显的抑制作用(P<0.01).结果提示阿托品雾化吸入可使哮喘患者FEV_1改善;预先吸入阿托品对IHV引起的支气管收缩反应有保护作用,此保护作用与患者的气道反应性大小及阿托品的支气管扩张作用无关.

Isocapnic hyperventilauon (IHV) with room temperature dry gas was evaluated in 12 asthmatic patients before and after pretreatment with placebo or atropine by inhalation. Baseline FEV, increased to 3.37±0.68 L after atropine inhalation from 2.28±0-62 L before (P<0.01). The IHV response index FEV1 was 31.0±14.6% before and shifted to 8.7±8.9% after inhalation of atropine (P<0.01). In order to get rid of the effect of baseline FEV1 changes induced by atropine inhalation, covariance analysis was used. Removing the influence of bronchodilation, atropine revealed marked suppression to IHV induced bronchoconstriction (P<0.01). The results suggest that atropine inhalation can improve the FEV1 in asthma. Inhaling atropine in advance has a preventive effect on bronchospasm induced by IHV, which has no correlation with airway reactivity and bronchodilative effect of atropine.