Stenton S C, Young C A, Harris A, Palmer J B, Hendrick D J, Walters E H
Chest Unit, Newcastle General Hospital, University of Newcastle upon Tyne, UK.
Pulm Pharmacol. 1992 Sep;5(3):199-202. doi: 10.1016/0952-0600(92)90041-e.
Airway responsiveness to methacholine was measured in nine subjects (22-53 years, seven male) with chronic stable asthma. All subjects were taking inhaled beclomethasone (less than 1000 micrograms daily). The mean baseline FEV1 was 2.841 (77% of predicted) and the geometric mean PD20FEV1 was 31 micrograms. After a run-in period, the subjects were randomly allocated to two treatment periods with the specific thromboxane receptor antagonist GR32191, 40 mg four times daily for 3 weeks, and identical placebo capsules. A double-blind, placebo-controlled, cross-over design was employed with 4 weeks between the two treatment periods. Treatment with GR32191 did not result in any significant improvement in mean FEV1 (2.941 after placebo and 2.861 after GR3219; F7.71 = 1.02, P greater than 0.1) or PD20FEV1 (24.3 micrograms after placebo and 38.5 micrograms after GR32191; F7.71 = 0.59, P greater than 0.1). We conclude that thromboxane is not important in the maintenance of airway hyperresponsiveness in chronic asthma and that thromboxane receptor antagonists are unlikely to provide effective treatment for this group of patients.
对9名患有慢性稳定型哮喘的受试者(年龄22 - 53岁,7名男性)进行了气道对乙酰甲胆碱的反应性测定。所有受试者均吸入倍氯米松(每日剂量小于1000微克)。平均基线第一秒用力呼气容积(FEV1)为2.841(预测值的77%),乙酰甲胆碱使FEV1下降20%所需剂量(PD20FEV1)的几何平均值为31微克。在经过一段导入期后,受试者被随机分配到两个治疗阶段,分别接受特异性血栓素受体拮抗剂GR32191治疗,每日4次,每次40毫克,持续3周,以及相同的安慰剂胶囊。采用双盲、安慰剂对照、交叉设计,两个治疗阶段之间间隔4周。GR32191治疗并未使平均FEV1(安慰剂治疗后为2.941,GR32191治疗后为2.861;F7,71 = 1.02,P大于0.1)或PD20FEV1(安慰剂治疗后为24.3微克,GR32191治疗后为38.5微克;F7,71 = 0.59,P大于0.1)有任何显著改善。我们得出结论,血栓素在慢性哮喘气道高反应性的维持中并不重要,血栓素受体拮抗剂不太可能为这类患者提供有效治疗。