慢性阻塞性肺疾病急性加重期不同剂量氨茶碱疗效、不良反应观察

Efficacy and adverse reactions of aminophylline at different doses in acute exacerbation of chronic obstructive pulmonary diseases

目的:观察不同剂量氨茶碱治疗慢性阻塞性肺疾病急性加重期(AECOPD)时的血药浓度、临床疗效、药物不良反应。方法:选择某院AECOPD患者210例,随机分为3组,每组70例,综合治疗上分别给予5 mg·kg^(-1)(A组)、6 mg·kg^(-1)(B组)、7 mg·kg^(-1)(C组)不同剂量氨茶碱静滴。比较3组间茶碱血药浓度、药物不良反应、用药前后6分钟步行试验(6MWT)、动脉血氧分压(PaO2)、一秒量(FEV1%)。结果:治疗后B组PaO2(72.13±5.27)mmHg,6MWT(364.26±48.38)m,C组PaO2(71.82±5.16)mmHg,6MWT(371.33±36.97)m,2组间差异无统计学意义,但较A组PaO2(62.95±8.31)mmHg,6MWT(303.87±45.99)m改善明显,差异有统计学意义(P<0.05)。3组FEV1%均较治疗前有改善,但组间差异无统计学意义。3组茶碱血药浓度均在正常范围,组间无差异,不良反应发生率C组5.7%较A组2.9%、B组1.4%明显升高,差异有统计学意义(P<0.05),A、B组间差异无统计学意义。结论:氨茶碱以6 mg·kg^(-1)静脉给药时,血药浓度在安全、有效范围,药物不良反应发生率低,可明显改善急性期患者缺氧状况和运动耐量。

OBJECTIVE To observe serum concentration,efficacy and adverse reactions of aminophylline at different doses in acute exacerbation of chronic obstructive pulmonary diseases（AECOPD）.METHODS Totally 210 AECOPD patients were selected and randomly divided into 3 groups,each group included70 patients.Aminophylline 5,6 and7 mg·kg^-1 were intravenously administered to patients in group A,B and C,respectively.Serum concentration of theophylline,adverse reactions,6 mi walk test（6MWT,before and after）,PaO_2（before and after）,One second volume（before and after,FEV1%）were recorded and compared.RESULTS PaO2 and 6MWT results after treatment：PaO2（72.13±5.27）mmHg and 6MWT（364.26±48.38）m in group B,PaO2（71.82±5.16）mmHg and 6MWT（371.33±36.97）m in group C,PaO2（62.95±8.31）mmHg and 6MWT（303.87±45.99）m in group A.No significant difference was observed between B and C.Compared with group A,these parameters were significantly improved（all P0.05）.FEV1% was improved in each group,however without significant difference.The theophylline serum concentrations in 3 groups were in normal range.Compared with2.9%in group A and 1.4%in group B,occurance of adverse drug reaction was higher in group C（5.7%,P0.05）.No significant difference was observed between group A and B.Theophylline serum concentration and adverse drug adverse was not correlated.CONCLUSION Aminophylline at 6 mg·kg^-1 produces blood drug concentrations in a safe and effective range,maximal efficacy and the lowest incidence of adverse reactions.