A combination with clinical recommended dosages of salmeterol and ipratropium is not more effective than salmeterol alone in patients with chronic obstructive pulmonary disease
A combination with clinical recommended dosages of salmeterol and ipratropium is not more effective than salmeterol alone in patients with chronic obstructive pulmonary disease
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DOI：
10.1016/s0954-6111(96)90178-x
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发表时间：
1996-09-01
影响因子：
4.3
通讯作者：
Cazzola, M
中科院分区：
文献类型：
--
作者：
Matera, MG;Caputi, M;Cazzola, M
胆碱能支气管运动张力的作用在对呼吸道口径有不利影响的情况下可能被放大。因此，有效的胆碱能阻滞剂对以呼吸道管径下降为表现的患者可能是有价值的。这在慢性阻塞性肺疾病(COPD)患者中尤其如此，因为哮喘患者的气道狭窄比迷走神经张力引起的因素更多，而迷走神经张力可能是COPD唯一可逆的因素(2)。虽然目前的抗胆碱能药在COPD中往往比P-激动剂更有效，但由于它们的支气管扩张持续时间更长，它们的起效可能更慢。因此，一些临床研究表明，在COPD的抗胆碱能药(如异丙托品)中添加一种P-激动剂的好处并不令人惊讶(3)。
The role of cholinergic bronchomotor tone may be magnified in circumstances which influence airway calibre adversely. Effective cholinergic blockade may, consequently, be of value in patients whose disease is manifested by decline in airway calibre (1). This is particularly true in chronic obstructive pulmonary disease (COPD) patients, because airway narrowing in asthma is due to more factors than vagal tone alone, whereas vagal tone may be the only reversible element in COPD (2).Although present anti-cholinergics often appear to be of greater efficacy than P-agonists in COPD, owing to their prolonged duration of bronchodilation, their onset of action may be slower (2). It is not a surprise, therefore, that a number of clinical studies have shown the benefit of adding a P-agonist to anti-cholinergics such as ipratropium in COPD (3).