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[沙丁胺醇和异丙托溴铵对稳定期慢性阻塞性肺疾病患者动脉血气的影响]

[Effects of salbutamol and ipratropium bromide on arterial blood gases in patients with stable COPD].

作者信息

Ozdemir Tülay, Geçkin Esra, Oğüş Candan, Cilli Aykut

机构信息

Akdeniz University Faculty of Medicine, Pulmonary Diseases, Antalya, Turkey.

出版信息

Tuberk Toraks. 2003;51(2):132-7.

Abstract

The aim of this study was to evaluate the acute effects of inhaled salbutamol and ipratropium bromide on arterial blood gases in patients with chronic obstructive pulmonary disease (COPD). We measured arterial blood gases and spirometry after inhalation of salbutamol (200 micro g) or ipratropium bromide (36 micro g) in 25 patients with COPD. After at least 2 days of washout period, the same patients inhaled the other drug, and the procedure of study was repeated. Blood specimens were taken just before the inhalation and at 5, 10, 20, 30, 60, 90,120 minutes after inhalation, and spirometry was done before and 60 minutes after inhalation. Both drugs caused a small decrease in PaO(2) levels, however the decrease in PaO(2) after inhalation of salbutamol was significantly higher than that after ipratropium (p< 0.05). Both drugs caused a little, but not statistically significant decrease in D(A-a)DO(2) and PaCO(2) (p> 0.05). There were a little increase in FEV1 and FVC at 60 minutes after inhalation of both drugs, especially with salbutamol, compared to ipratropium bromide; but both increases were statistically insignificant (p> 0.05). The results revealed that, salbutamol caused a significant, but small and transient decrease in PaO2 and a little, but insignificant increase in D(A-a)DO(2) when used in recommended doses. Although salbutamol and ipratropium bromide which are used in treatment of COPD, can cause small decreases in PaO(2) after inhalation, the declines are trancient and clinically insignificant.

摘要

本研究的目的是评估吸入沙丁胺醇和异丙托溴铵对慢性阻塞性肺疾病(COPD)患者动脉血气的急性影响。我们对25例COPD患者吸入沙丁胺醇(200微克)或异丙托溴铵(36微克)后的动脉血气和肺功能进行了测量。在至少2天的洗脱期后,同一批患者吸入另一种药物,并重复研究过程。在吸入前以及吸入后5、10、20、30、60、90、120分钟采集血样,在吸入前和吸入后60分钟进行肺功能测定。两种药物均导致PaO₂水平略有下降,然而吸入沙丁胺醇后PaO₂的下降显著高于吸入异丙托溴铵后(p<0.05)。两种药物均使D(A-a)DO₂和PaCO₂略有下降,但无统计学意义(p>0.05)。与异丙托溴铵相比,吸入两种药物后60分钟时FEV1和FVC均略有增加,尤其是沙丁胺醇;但两者的增加均无统计学意义(p>0.05)。结果显示,按推荐剂量使用时,沙丁胺醇会导致PaO₂显著但微小且短暂的下降以及D(A-a)DO₂略有增加但无显著意义。尽管用于治疗COPD的沙丁胺醇和异丙托溴铵吸入后可导致PaO₂略有下降,但这种下降是短暂的且临床意义不大。

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