在囊性纤维化患者中使用HaloLite雾化器和Pari LC Plus雾化器对黏菌素肺部沉积情况的比较。
Comparison of lung deposition of colomycin using the HaloLite and the Pari LC Plus nebulisers in patients with cystic fibrosis.
作者信息
Byrne N M, Keavey P M, Perry J D, Gould F K, Spencer D A
机构信息
Regional Paediatric Cystic Fibrosis Unit, Newcastle upon Tyne Hospitals NHS Trust, UK.
出版信息
Arch Dis Child. 2003 Aug;88(8):715-8. doi: 10.1136/adc.88.8.715.
AIM
To examine the effectiveness of delivery of nebulised colistin by the HaloLite nebuliser compared to the Pari LC Plus in patients with cystic fibrosis.
METHODS
Randomised crossover trial of 15 patients aged >6 years. Inhalation of one mega unit of colistin in 3 ml diluent, labelled with technetium-99m DTPA, was used to assess lung deposition. The Pari was nebulised to dryness and one button press of the HaloLite was completed. Following a seven day washout period, patients inhaled colistin twice daily for seven days through the first device. Sputum specimens were analysed for colistin levels and pseudomonas load. This procedure was repeated with the alternative device.
RESULTS
Lung uptake of radiolabelled colistin was significantly higher with the Pari. However, lung uptake calculated as a percentage of the amount of drug used was significantly higher for the HaloLite. Time to nebulise was significantly shorter with the HaloLite. Sputum levels of colistin were higher following use of the Pari; this was close to significance.
CONCLUSION
The manufacturer's recommended dosages for nebulising antibiotics with a HaloLite result in a lower delivery than patients receive when using a Pari nebuliser. The concept of adaptive aerosol delivery has several theoretical advantages but the recommended doses for the HaloLite need to be modified in order to improve effectiveness.
目的
比较HaloLite雾化器与Pari LC Plus雾化器在囊性纤维化患者中雾化吸入黏菌素的效果。
方法
对15名年龄大于6岁的患者进行随机交叉试验。吸入3毫升稀释液中含100万单位黏菌素（用99m锝-二乙三胺五乙酸标记），以评估肺部沉积情况。将Pari雾化器雾化至干燥，完成一次HaloLite雾化器的按键操作。经过7天的洗脱期后，患者通过第一种装置每日两次吸入黏菌素，共7天。对痰液标本进行黏菌素水平和铜绿假单胞菌载量分析。用另一种装置重复此过程。
结果
Pari雾化器对放射性标记黏菌素的肺部摄取显著更高。然而，以所用药物量的百分比计算，HaloLite雾化器的肺部摄取显著更高。HaloLite雾化器的雾化时间显著更短。使用Pari雾化器后痰液中黏菌素水平更高；这接近显著水平。
结论
按照制造商推荐剂量使用HaloLite雾化器雾化抗生素时，其药物递送量低于患者使用Pari雾化器时的药物递送量。适应性气溶胶递送的概念有若干理论优势，但需要修改HaloLite雾化器的推荐剂量以提高有效性。
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