沙丁胺醇对COPD患者纤维支气管镜检查安全性的影响

Safety of Salbutamol for Bronchoscopy in Patients with COPD

目的:探讨沙丁胺醇对慢性阻塞性肺疾病(COPD)患者纤维支气管镜检查的影响与安全性。方法:80例COPD患者行纤维支气管镜检查的患者纳入研究,随机分为沙丁胺醇组(n=40)和安慰剂组(n=40)。沙丁胺醇组检查前15分钟给予吸入沙丁胺醇200μg,安慰剂组吸入生理盐水。比较两组检查前、检查中和检查后血氧饱和度、心率和血压的变化情况及检查前后FEV1占预测值的百分数降低程度。结果:①血氧饱和度、血压和心率沙丁胺醇组与安慰剂组比较差异无统计学意义(p>0.05);②支气管镜检查前后,沙丁胺醇组FEV1占预计值的百分数下降4.7%,安慰剂组下降4.8%,两组比较差异无统计学意义(p=0.432);③支气管镜检查后FEV1下降与COPD的严重程度有关(r=-0.314,p=0.01)。结论:COPD患者行纤维支气管镜检查前不推荐吸入短效支气管扩张剂沙丁胺醇。

Objective：To evaluate the effect of using a short-acting bronchodilator in patients with COPD who were undergoing bronchoscopy.Methods：80 COPD patients undergoing bronchoscopy were randomized to receive either 200mg of salbutamol（n=40） or placebo（n=40） before bronchoscopy.Control patients did not receive any inhaled medication.Spirometry was performed before and 2 h after bronchoscopy in all patients,and hemodynamic parameters were recorded.Results：Hemodynamic findings before,during,and after bronchoscopy were similar between salbutamol and placebo group（p0.05）.Compared with prebronchoscopy,postbronchoscopy percentage of predicted FEV1 decreased significantly in the two groups：salbutamol group median is 4.7%,placebo group median is 4.8%（p= 0.432）.The decrease in percentage of predicted FEV1 was similar in the two groups.The decrease of percentage of predicted FEV1 was correlated to the increasing severity of COPD（r=-0.314,p=0.01）.Conclusion：Premedication with an inhaled salbutamol cannot be recommended in patients with COPD undergoing bronchoscopy.