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[袢利尿剂与哮喘治疗]

[Loop diuretics and the treatment of asthma].

作者信息

Popin E, Pauli G

机构信息

CHRU, Strasbourg.

出版信息

Rev Mal Respir. 1992;9(5):491-4.

PMID:1439088
Abstract

Current data in the literature show a protective effect of loop diuretics in relation to certain types of experimental bronchospasm. This action has sometimes been observed after the administration of diuretics as aerosols in less severe cases of asthma. The initial observations on bronchospasm induced by physical stimuli (exercise, distilled water and hyperventilation), have been extended to bronchospasm provoked by allergens or certain chemical stimuli (metabisulphide, adenosine 5'-monophosphate, and salicylic acid). On the other hand provocation tests using histamine or acetylcholine are modified, either a little or not at all by diuretics. The proposed mechanisms of action are multiple, but are still very hypothetical: an action on ionic fluxes in the epithelial cells, in mastocytes, in nerve cells and in muscle cells inducing the secretion of prostaglandin. Diuretics certainly have opened some interesting patho-physiological approaches, but current data concerning their efficacy in asthmatics are still fragmentary and do not, at the current time, allow them to take a significant place in the therapeutic arsenal of asthma drugs.

摘要

文献中的现有数据表明,袢利尿剂对某些类型的实验性支气管痉挛具有保护作用。在哮喘较轻的病例中,有时在以气雾剂形式使用利尿剂后会观察到这种作用。最初对由物理刺激(运动、蒸馏水和过度通气)诱发的支气管痉挛的观察,已扩展到由过敏原或某些化学刺激(偏亚硫酸氢盐、5'-单磷酸腺苷和水杨酸)引发的支气管痉挛。另一方面,使用组胺或乙酰胆碱的激发试验,会受到利尿剂的轻微影响或不受影响。所提出的作用机制是多方面的,但仍然非常具有假设性:对上皮细胞、肥大细胞、神经细胞和肌肉细胞中的离子通量产生作用,从而诱导前列腺素的分泌。利尿剂确实开辟了一些有趣的病理生理学研究途径,但目前关于它们在哮喘患者中疗效的数据仍然支离破碎,目前还无法使它们在哮喘药物治疗手段中占据重要地位。

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