Beach J R, Young C L, Stenton S C, Avery A J, Walters E H, Hendrick D J
Chest Unit, Newcastle General Hospital, University of Newcastle upon Tyne, UK.
Pulm Pharmacol. 1992 Jun;5(2):133-5. doi: 10.1016/0952-0600(92)90031-b.
We compared the speed of action of the long acting beta-agonist salmeterol with that of salbutamol in order to assess whether reported in vitro differences are likely to have clinical significance. We used methacholine tests to produce a standardized level of bronchoconstriction and then observed the rate of recovery of FEV1 towards baseline after the administration by metered dose inhaler of salmeterol 50 micrograms or salbutamol 200 micrograms--doses which are considered to have similar bronchodilator potency. Twenty asthmatic subjects participated, and a double-blind, randomized, cross-over study design was followed. Salmeterol showed a significantly slower speed of action with median recovery to 90% and 95% of the baseline FEV1 (pre-methacholine) occurring after 9.6 and 19.4 min, respectively, compared with 4.8 and 8.3 min, respectively, for salbutamol (P less than 0.01). These observations are consistent with in vitro findings and suggest that salmeterol is likely to be less satisfactory than salbutamol as a 'rescue medication' for the treatment of acute episodes of bronchoconstriction.
我们比较了长效β受体激动剂沙美特罗与沙丁胺醇的起效速度，以评估体外实验中所报道的差异是否可能具有临床意义。我们采用乙酰甲胆碱试验来产生标准化的支气管收缩水平，然后通过定量吸入器分别给予50微克沙美特罗或200微克沙丁胺醇（这两种剂量被认为具有相似的支气管扩张效力），之后观察第一秒用力呼气容积（FEV1）恢复至基线水平的速率。20名哮喘患者参与了研究，采用双盲、随机、交叉研究设计。沙美特罗的起效速度明显较慢，FEV1恢复至基线水平的90%和95%（用药前乙酰甲胆碱激发试验时的基线水平）的中位时间分别为9.6分钟和19.4分钟，而沙丁胺醇分别为4.8分钟和8.3分钟（P<0.01）。这些观察结果与体外实验结果一致，表明在治疗支气管收缩急性发作时，作为“急救药物”，沙美特罗可能不如沙丁胺醇有效。
