Broeders Mariëlle E A C, Molema Johan, Hop Wim C J, Vermue Niek A, Folgering Hans T M
Department of Pulmonary Diseases, Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560 GB Groesbeek, The Netherlands.
Eur J Clin Pharmacol. 2003 Sep;59(5-6):449-55. doi: 10.1007/s00228-003-0614-2. Epub 2003 Aug 12.
This open randomized study examined differences between the effects of an equal dose of salbutamol administered via the Diskus, Turbuhaler, and pMDI plus Volumatic. Measurements included dose response curves, dynamic and static lung volumes, respiratory muscle strength, and systemic effects.
The cumulative dose-response study compared the biological effects (pulmonary function, respiratory muscle function, systemic effects) of an equal dose of salbutamol delivered via four different devices in 23 patients with asthma and 21 patients with moderate or severe chronic obstructive pulmonary disease (COPD).
Salbutamol via Volumatic showed significantly better bronchodilation than via pMDI or Turbuhaler in both patient groups. No significant difference was found between salbutamol via Volumatic and Diskus. However, the advantage of Volumatic is of marginal clinical relevance since the additional bronchodilation was a maximum of 140 ml FEV(1) and did not exceed the minimal patient-perceivable improvement. In the asthma group a more evident plasma K(+) decrease was found after salbutamol delivered via pMDI and pMDI plus Volumatic. Furthermore, especially in the COPD patients a significant decrease was observed in hyperinflation and consequently an improvement in maximal inspiratory pressure as a result of salbutamol via all devices.
Bronchodilation by salbutamol was slightly more effective via Volumatic than via pMDI or Turbuhaler. No significant difference in bronchodilation was found between salbutamol via Volumatic and Diskus. The advantage of Volumatic is not of clinical relevance.
本开放性随机研究比较了同等剂量沙丁胺醇通过都保、准纳器和压力定量吸入器（pMDI）加储雾罐给药后的效果差异。测量指标包括剂量反应曲线、动态和静态肺容积、呼吸肌力量及全身效应。
这项累积剂量反应研究比较了23例哮喘患者和21例中重度慢性阻塞性肺疾病（COPD）患者使用四种不同装置吸入同等剂量沙丁胺醇后的生物学效应（肺功能、呼吸肌功能、全身效应）。
在两组患者中，沙丁胺醇通过储雾罐给药时的支气管扩张效果显著优于通过pMDI或准纳器给药。沙丁胺醇通过储雾罐给药与通过都保给药之间未发现显著差异。然而，储雾罐的优势在临床方面意义不大，因为额外的支气管扩张最大为140 ml第一秒用力呼气容积（FEV₁），未超过患者可感知的最小改善程度。在哮喘组中，通过pMDI和pMDI加储雾罐给药后，血浆钾（K⁺）下降更为明显。此外，尤其是在COPD患者中，使用所有装置吸入沙丁胺醇后，肺过度充气显著减少，最大吸气压因此得到改善。
沙丁胺醇通过储雾罐给药时的支气管扩张效果略优于通过pMDI或准纳器给药。沙丁胺醇通过储雾罐给药与通过都保给药之间未发现支气管扩张效果的显著差异。储雾罐的优势无临床意义。
