Sposato B, Mariotta S, Ricci A, Bruno P, Terzano C, Mannino F
Dipartimento di Scienze Cardiovascolari e Respiratorie, Università La Sapienza, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2005 Mar-Apr;9(2):117-23.
The protective effect of Ipratropium Bromide (IB) in the methacholine-induced bronchospasm is well known from some time. The objective of the present study was to assess whether a pretreatment with IB may influence the subsequent phase of methacholine-induced bronchospasm relief.
Sixteen patients with bronchial hyper-reactivity (PD20 FEV1 < 200 microg) were randomly assigned to three methacholine challenge tests at a 48 to 72 hours interval apart. In the first test IB was inhaled before the challenge (pre-IB), in the second IB was administered soon after the PD20 FEV1 (post-IB), and in the third no treatment was given (control).
The pre-IB PD20 FEV1 (695 +/- 587.6 microg) was significantly greater (p < 0.0001) than that of post-IB (82.2 +/- 49.18 microg) and of control (73.9 +/- 41.8 microg). The dose response slope (DRS) (decline percentage of FEV1/cumulative methacholine dose), in pre-IB was greatly lower (p < 0.0001) than that in post-IB and in control. During the bronchospasm relief phase, the increase of FEV1 measured after 5, 10, 15, 30 and 60 minutes from the PD20 FEV1 was significantly greater in post-IB (p < 0.05) compared with the other two conditions. Conversely, the recovery slope (RS) (increase percentage of FEV1 at 60 minutes after PD20 FEV1 x cumulative methacholine dose) was significantly more efficient (p < 0.001) in pre-IB than in post-IB and in control.
In conclusion, ipratropium bromide confirmed to have a good protective activity against methacholine-induced bronchospasm; the pre-administration of ipratropium bromide showed also a positive effect on the recovery phase.
异丙托溴铵（IB）对乙酰甲胆碱诱发的支气管痉挛的保护作用已为人所知有一段时间了。本研究的目的是评估IB预处理是否会影响随后乙酰甲胆碱诱发的支气管痉挛缓解阶段。
16例支气管高反应性患者（PD20 FEV1<200微克）每隔48至72小时随机进行三次乙酰甲胆碱激发试验。在第一次试验中，在激发前吸入IB（激发前IB），在第二次试验中，在达到PD20 FEV1后立即给予IB（激发后IB），第三次试验不给予任何治疗（对照）。
激发前IB的PD20 FEV1（695±587.6微克）显著高于激发后IB（82.2±49.18微克）和对照（73.9±41.8微克）（p<0.0001）。激发前IB的剂量反应斜率（DRS）（FEV1下降百分比/累积乙酰甲胆碱剂量）显著低于激发后IB和对照（p<0.0001）。在支气管痉挛缓解阶段，与其他两种情况相比，激发后IB在达到PD20 FEV1后5、10、15、30和60分钟测量的FEV1增加显著更大（p<0.05）。相反，恢复斜率（RS）（达到PD20 FEV1后60分钟FEV1增加百分比×累积乙酰甲胆碱剂量）在激发前IB中比激发后IB和对照显著更有效（p<0.001）。
总之，异丙托溴铵被证实对乙酰甲胆碱诱发的支气管痉挛具有良好的保护活性；异丙托溴铵的预先给药对恢复阶段也显示出积极作用。
