溴化异丙托品和β_2受体激动剂雾化吸入治疗COPD急性发作

Efficacy of β_2-agonist and Impratropium Bromide in Chronic Obstructive Pulmonary Disease

目的 探讨β2 受体激动剂和抗胆碱药单用及联合应用治疗慢性阻塞性肺病 (COPD)患者急性发作期的疗效。方法 6 0例COPD急性发作期患者随机分为A、B、C 3组 ,分别射流雾化吸入 0 .0 2 5 %溴化异丙托品溶液 2mL、0 .5 %非诺特罗氢溴化物溶液 0 .2 5mL、含溴化异丙托品 0 .5mg和沙丁胺醇 2 .5mg溶液 2 .5mL。比较各组在吸入药物前和吸入药物后 2 0、40、6 0及 12 0minFVC和FEV1%的变化 ,吸入药物前后动脉血气分析结果 ,并观察药物不良反应。结果 A、B、C 3组在用药后FEV1%和FVC均有改善 ,FEV1%改善率分别为 2 0 .6 %、2 2 .8%、2 6 .5 % ,FVC改善率 15 .8%、17.8%、2 0 .6 %。C组作用维持时间最长 ,作用高峰时FEV1%和FVC改善率较A、B组为高 ,有统计学意义。用药前后动脉血气分析结果各组间无显著差异 ,每组与治疗前相比也无显著差异。各组均未见明显不良反应。结论 溴化异丙托品、β2 受体激动剂均能有效改善COPD患者急性发作期FEV1%和FVC ,联合用药能延长药物作用时间。

Purpose: To compare the efficacy and safety of β2-agonist and impratropium bromide incombination vs either agent alone in chronic obstructive pulmonary disease (COPD). Methods: 60 patients with acute exabration of COPD were randomized into 3 groups. Each group received 2.0 mL of inhaled 0. 025% impratropium bromide, 0.25 mL of inhaled 0.5% fenoterol Hbr or 2. 5 mL of inhaled impratropium bromide plus salbutamol sulfate. Lung funtion was assessed before drug administration and 20,40,60,120 min thereafter. At the end of 2 h period, each patient received blood gas analysis. Results: All three groups significantly improved in FEV1% FVC compared with baseline. Combination treatment with salbutamol sulfate plus impratropium bromide provided significantly (P < 0. 05) greater improvements in polmonary function and the efficacy lasted longer than bronchodilators given alone. Conclusions: Patients with acute exabration of COPD may benefit from combination treatment with beta2-agonist plus impratropium bromide without a resulting increase in adverse events.