Lavorini F, Fontana G A, Pantaleo T, Camiciottoli G, Castellani W, Maluccio N M, Pistolesi M
Dipartimento di Area Critica Medico Chirurgica, Sezione di Medicina Respiratoria, Università di Firenze, Florence, Italy.
Am J Respir Crit Care Med. 2001 Apr;163(5):1117-20. doi: 10.1164/ajrccm.163.5.2005046.
Fog inhalation induces cough and bronchoconstriction in patients with asthma, but only cough in normal subjects; whether it also influences the pattern of breathing is unclear. Nedocromil sodium (NCS) inhibits the cough response to inhalation of several pharmacological agents but its effects on fog-induced cough and changes in the pattern of breathing are unknown. We evaluated the effects of no drug, placebo, and 4- and 8-mg NCS administration on the cough threshold and changes in the pattern of breathing during fog inhalation in 14 healthy subjects. Measurements of tidal volume (VT), duration of inspiratory and expiratory times (TI and TE, respectively), total duration of the respiratory cycle (TT), mean inspiratory flow (VT/TI), duty cycle (TI/TT), respiratory frequency (f, 60/TT), and inspiratory minute ventilation (V I) were obtained by inductive plethysmography. Median cough threshold values were unaffected by placebo, but were increased (p < 0.01) by both NCS doses. In no-drug and placebo trials, inhalation of the threshold fog concentration caused increases in both VT/TI and V I (p always < 0.05) due to selective increases (p < 0.01) in VT. These changes were markedly attenuated by both NCS doses administration. Thus, fog induces coughing and increases in VT, VT/ TI, and V I in healthy subjects; NCS possesses antitussive effects and attenuates fog-induced changes in the pattern of breathing, possibly through inhibition of rapidly adapting "irritant" receptors.
雾化吸入可诱发哮喘患者咳嗽和支气管收缩,但仅诱发正常受试者咳嗽;其是否还会影响呼吸模式尚不清楚。奈多罗米钠(NCS)可抑制对多种吸入药理剂的咳嗽反应,但其对雾化诱发咳嗽及呼吸模式变化的影响尚不清楚。我们评估了无药物、安慰剂以及4毫克和8毫克NCS给药对14名健康受试者雾化吸入期间咳嗽阈值及呼吸模式变化的影响。通过感应式体积描记法测量潮气量(VT)、吸气和呼气时间(分别为TI和TE)、呼吸周期总时长(TT)、平均吸气流量(VT/TI)、占空比(TI/TT)、呼吸频率(f,60/TT)和吸气分钟通气量(VI)。安慰剂对咳嗽阈值中位数无影响,但两种剂量的NCS均使其升高(p<0.01)。在无药物和安慰剂试验中,吸入阈值雾化浓度会导致VT/TI和VI均升高(p始终<0.05),原因是VT选择性升高(p<0.01)。两种剂量的NCS给药均显著减弱了这些变化。因此,雾化可诱发健康受试者咳嗽,并使VT、VT/TI和VI升高;NCS具有镇咳作用,并减弱雾化诱发的呼吸模式变化,可能是通过抑制快速适应性“刺激”感受器实现的。