Abreu González Juan, Hernández García Concepción, Abreu González Pedro, Martín García Candelaria, Jiménez Alejandro
Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España.
Arch Bronconeumol. 2006 Aug;42(8):384-7. doi: 10.1016/s1579-2129(06)60551-x.
Magnesium sulfate has been shown to have a bronchodilating effect in asthma, but this effect has not been clearly established in the context of chronic obstructive pulmonary disease (COPD). For this reason we investigated the possible bronchodilating effect of magnesium sulfate in COPD exacerbations.
We studied 24 patients with exacerbated COPD who required admission to our hospital's pneumology department. All patients underwent baseline spirometry and were subsequently randomized to groups in a double-blind crossover design. Patients received 1.5 g of magnesium sulfate or placebo in an intravenous solution for 20 minutes. Those who received magnesium sulfate the first day were given placebo the second day, and vice versa. Spirometry was performed 15, 30, and 45 minutes after administration of magnesium sulfate or placebo. Finally, 400 microg of salbutamol were administered using a spacer and a final spirometry was performed 15 minutes later. All patients also received treatment with corticosteroids, intravenous antibiotics, oxygen, and regularly-scheduled bronchodilator therapy (salbutamol and ipratropium bromide every 6 hours).
When we compared absolute increase in milliliters and percentage increase in forced expiratory volume in 1 second (FEV1) obtained with magnesium sulfate application to the increases obtained with placebo after 15, 30, and 45 minutes, no significant differences were found. When we compared absolute and percentage increases in FEV1 after administering salbutamol, we found significantly greater increases after magnesium sulfate administration. The mean (SD) absolute increase in FEV1 was 0.18 [corrected] (0.42) L after magnesium sulfate administration and 0.081 [0.01] L after placebo (P=.004). The percentage increase in FEV1 was 17.11% (3.7%) after magnesium sulfate and 7.06% (1.8%) after placebo (P=.008).
Intravenous administration of magnesium sulfate has no bronchodilating effect in patients with COPD exacerbations. It does, however, enhance the bronchodilating effect of inhaled ss2-agonists.
硫酸镁已被证明在哮喘中具有支气管扩张作用，但在慢性阻塞性肺疾病（COPD）背景下，这种作用尚未明确确立。因此，我们研究了硫酸镁在COPD急性加重期可能的支气管扩张作用。
我们研究了24例因COPD急性加重而需入住我院呼吸内科的患者。所有患者均进行了基线肺功能测定，随后采用双盲交叉设计随机分组。患者接受1.5g硫酸镁或安慰剂静脉输注20分钟。第一天接受硫酸镁的患者第二天给予安慰剂，反之亦然。在输注硫酸镁或安慰剂后15、30和45分钟进行肺功能测定。最后，使用储雾罐给予400μg沙丁胺醇，并在15分钟后进行最后一次肺功能测定。所有患者还接受了皮质类固醇、静脉抗生素、氧气和定期支气管扩张剂治疗（每6小时给予沙丁胺醇和异丙托溴铵）。
当我们比较在15、30和45分钟时应用硫酸镁后获得的1秒用力呼气容积（FEV1）的毫升绝对增加值和百分比增加值与应用安慰剂后的增加值时，未发现显著差异。当我们比较给予沙丁胺醇后FEV1的绝对增加值和百分比增加值时，我们发现硫酸镁给药后增加值显著更大。硫酸镁给药后FEV1的平均（标准差）绝对增加值为0.18[校正后]（0.42）L，安慰剂给药后为0.081[0.01]L（P = 0.004）。硫酸镁给药后FEV1的百分比增加值为17.11%（3.7%），安慰剂给药后为7.06%（1.8%）（P = 0.008）。
静脉注射硫酸镁对COPD急性加重期患者无支气管扩张作用，但它确实能增强吸入性β2受体激动剂的支气管扩张作用。
