Borut T C, Tashkin D P, Fischer T J, Katz R, Rachelefsky G, Siegel S C, Lee E, Harper C
J Allergy Clin Immunol. 1977 Aug;60(2):127-33. doi: 10.1016/0091-6749(77)90038-0.
The new anticholinergic compound Sch 1000 (ipratropium bromide) has been reported to be an effective bronchodilator without significant atropine-like side effects. We evaluated the effectiveness of different doses of nebulized Sch 1000 (40 microgram and 80 microgram) aerosolized atropine sulfate (1 mg) and placebo in the prevention of exercise-induced bronchospasm (EIB) in 20 children with atopic bronchial asthma. A random, crossover double-blind protocol was used. Standard exercise on a cycloergometer was used to induce EIB. Pulmonary function was determined before and after drug administration and exercise. Following no treatment or placebo, exercise resulted in average reductions of 33% to 43% in plethysmographic specific airway conductance (SGaw), of 20% to 25% in forced expiratory volume in 1 sec (FEV1), and of 25% to 32% in maximal midexpiratory flow rate. Exercise following no treatment or placebo resulted in average increases of 23% to 30% in thoracic gas volume (Vtg). Prior to exercise atropine and either dose of Sch 1000 caused significant increases in SGaw (48% to 59%). After pretreatment with Sch 1000 or atropine, exercise caused SGaw to fall to values that were not significantly different from pretreatment medication values, but were significantly higher than values following exercise without pretreatment or after pretreatment with placebo. No significant differences were noted between the effects of atropine and Sch 1000 on EIB. We conclude that at the doses used atropine and Sch 1000 cause equivalent degrees of bronchodilation but neither drug specifically inhibits EIB.
据报道，新型抗胆碱能化合物Sch 1000（异丙托溴铵）是一种有效的支气管扩张剂，且无明显的阿托品样副作用。我们评估了雾化吸入不同剂量的Sch 1000（40微克和80微克）、硫酸阿托品（1毫克）和安慰剂对20例特应性支气管哮喘患儿运动诱发性支气管痉挛（EIB）的预防效果。采用随机、交叉双盲方案。使用标准的蹬车测力计运动来诱发EIB。在给药和运动前后测定肺功能。未经治疗或使用安慰剂后，运动导致体积描记法特异性气道传导率（SGaw）平均降低33%至43%，第1秒用力呼气量（FEV1）降低20%至25%，最大呼气中期流速降低25%至32%。未经治疗或使用安慰剂后运动导致胸腔气体容积（Vtg）平均增加23%至30%。运动前，阿托品和两种剂量的Sch 1000均使SGaw显著增加（48%至59%）。用Sch 1000或阿托品预处理后，运动导致SGaw降至与预处理用药后的值无显著差异，但显著高于未预处理或用安慰剂预处理后运动的值。阿托品和Sch 1000对EIB的作用无显著差异。我们得出结论，在所使用的剂量下，阿托品和Sch 1000引起的支气管扩张程度相当，但两种药物均不能特异性抑制EIB。
