EFFECT OF INHALED METAPROTERENOL ON EXERCISE PERFORMANCE IN PATIENTS WITH STABLE FIXED AIRWAY-OBSTRUCTION
EFFECT OF INHALED METAPROTERENOL ON EXERCISE PERFORMANCE IN PATIENTS WITH STABLE FIXED AIRWAY-OBSTRUCTION
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DOI：
10.1164/ajrccm/138.3.624
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发表时间：
1988-09-01
期刊：
影响因子：
--
通讯作者：
SMITH, D
中科院分区：
文献类型：
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作者：
BERGER, R;SMITH, D
我们研究了10例中度至重度不可逆慢性阻塞性肺疾病（COPD）患者吸入异丙肾上腺素对运动能力的影响，定义为FEV1/FVC比值低于60%，并且在一次性吸入异丙肾上腺素和口服茶碱、吸入异丙肾上腺素和口服泼尼松的10天治疗试验后，FEV1和FVC改善均小于15%。基线评估后，在两个独立的日子，所有选定的患者进行肺功能测定和自行起搏12分钟平板步行试验（双盲交叉方式）之前和之后随机吸入5喷异丙肾上腺素或安慰剂。几周后，在吸入异丙肾上腺素之前和之后重复了单盲测试，但这次是在封闭的大厅里进行12分钟的步行。在所有研究日，治疗前肺功能测定值相似，并且在给予安慰剂或奥西那林后，没有受试者的FEV1或FVC发生显著变化（较基线> 15%）。后元丙肾上腺素跑步机和大厅步行距离平均改善（. ±. SD）112.+-。56 m（p <0.001）和82. ±. 46 m（p <0.01）。运动能力的个体改善与FEV1或FVC的相应变化或基线DLCO测量值无关。我们的结论是，一个客观的改善后，给予相对高剂量的吸入性奥西那林可以看到在一些中度至重度的“固定”气道阻塞的患者，尽管缺乏显着的反应，判断传统的肺功能标准。
We studied the effect of inhaled metaproterenol on exercise performance in ten patients with moderate to severe nonreversible chronic obstructive pulmonary disease (COPD), defined as a FEV1/FVC ratio below 60%, and less than 15% improvement in FEV1 and FVC after both one-time administration of inhaled metaproterenol and a 10-day therapeutic trial with oral theophylline, inhaled metaproterenol, and oral prednisone. After baseline evaluation, on two separate days all selected patients had spirometry and a self-paced 12-min treadmill walking test performed (in double-blind crossover fashion) before and after random administration of five puffs of inhaled metaproterenol or placebo. A few weeks later, testing was repeated single-blind before and after inhaled metaproterenol, but this time the 12-min walk was done in an enclosed hall. Pretreatment spirometry values were similar on all study days, and none of the subjects had a significant change (> 15% from baseline) in FEV1 or FVC after the administration of placebo or metaproterenol. The postmetaproterenol treadmill and hall walking distances improved by a mean (.+-. SD) of 112 .+-. 56 m (p < 0.001) and 82 .+-. 46 m (p < 0.01), respectively. Individual improvements in exercise performance did not correlate with the corresponding changes in FEV1 or FVC, or with the baseline DLCO measurement. We conclude that an objective improvement in physical performance after administration of a relatively high dose of inhaled metaproterenol can be seen in some patients with moderate to severe "fixed" airway obstruction, despite a lack of significant response as judged by conventional spirometry criteria.