Dewar M H, Jamieson A, McLean A, Crompton G K
Respiratory Medicine Unit, Western General Hospital, Edinburgh, U.K.
Respir Med. 1999 May;93(5):342-4. doi: 10.1016/s0954-6111(99)90316-5.
Many patients with chronic obstructive airways disease (COAD) receive therapy by the inhaled route. This study was performed to assess whether patients with severe COAD could generate sufficient peak inspiratory flow (PIF) through Turbuhaler (Astra, Sodertalje) to operate it effectively. One hundred patients (45 men, 55 women, mean age 69.1 years) with COAD (mean (SD) duration 17.7 (16.3) years) and peak expiratory flow (PEF) < or = 200 l min-1 or forced expiratory volume in 1 sec (FEV1) < or = 1 litre were studied. A series of randomly assigned inspiratory and expiratory lung function tests were contiguously performed, using portable spirometers, within 48 h of a screening visit. An empty Turbuhaler was used in the study. The patients' normal medication was not restricted. Sixty-six patients were previous smokers, eight occasional smokers, 19 habitual smokers and seven had never smoked. Mean (SD) FEV1 was 0.7 (0.2) 1 and mean PEF was 182 (68) l min-1. All patients were able to generate PIF through Turbuhaler (PIF-T) of 28 l min-1 (mean 53; range 28-78 l min-1). Eighty-three patients generated PIF-T of > or = 40 l min-1. PIF-T correlated with PIF without Turbuhaler (r = 0.35), PEF (r = 0.3), FEV1 (r = 0.2) and forced vital capacity (FVC) (r = 0.23) although the relationships were too weak to be used to predict PIF-T. The results suggest that patients with severely limited lung function caused by COAD can operate Turbuhaler effectively.
许多慢性阻塞性气道疾病（COAD）患者通过吸入途径接受治疗。本研究旨在评估重度COAD患者能否通过都保（Astra，南泰利耶）产生足够的吸气峰流速（PIF）以有效使用它。对100例COAD患者（45例男性，55例女性，平均年龄69.1岁，平均（标准差）病程17.7（16.3）年，呼气峰流速（PEF）≤200升/分钟或第1秒用力呼气容积（FEV1）≤1升）进行了研究。在筛查就诊的48小时内，使用便携式肺量计连续进行一系列随机分配的吸气和呼气肺功能测试。研究中使用的是一个空的都保。患者的常规药物治疗未受限制。66例患者既往吸烟，8例偶尔吸烟，19例经常吸烟，7例从不吸烟。平均（标准差）FEV1为0.7（0.2）升，平均PEF为182（68）升/分钟。所有患者都能够通过都保产生28升/分钟（平均53；范围28 - 78升/分钟）的吸气峰流速（PIF - T）。83例患者产生的PIF - T≥40升/分钟。PIF - T与不使用都保时的PIF（r = 0.35）、PEF（r = 0.3）、FEV1（r = 0.2）和用力肺活量（FVC）（r = 0.23）相关，尽管这些关系太弱，无法用于预测PIF - T。结果表明，由COAD导致肺功能严重受限的患者能够有效使用都保。
