静脉注射硫酸镁对急性哮喘的标准治疗并无额外益处。

Intravenous magnesium sulphate provides no additive benefit to standard management in acute asthma.

作者信息

Bradshaw Tracey A, Matusiewicz Simon P, Crompton Graham K, Innes J Alastair, Greening Andrew P

机构信息

Respiratory Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.

出版信息

Respir Med. 2008 Jan;102(1):143-9. doi: 10.1016/j.rmed.2007.07.022. Epub 2007 Sep 14.

DOI:10.1016/j.rmed.2007.07.022

PMID:17869079

Abstract

BACKGROUND

Treatment of acute asthma is based on rapid reversal of bronchospasm and airway inflammation. Magnesium sulphate (MgSO(4)) is known to have a bronchodilator effect on smooth muscle but studies have shown conflicting results on its efficacy in acute asthma, although its use is recommended in national and international guidelines.

AIMS

To determine if intravenous MgSO(4), when used as an adjunct to standard therapy, improves the outcome in acute asthma.

METHODS

A double blind, randomised placebo controlled trial comparing 1.2g MgSO(4) with standard therapy in adult patients with acute asthma. Patients had a PEF <or=75% predicted and all were treated with oxygen, nebulised salbutamol and ipratropium, and IV hydrocortisone. They then received 1.2g IV MgSO(4) or placebo. Outcome measures were % predicted PEF at 60 min and hospital admission rates.

RESULTS

One hundred and twenty nine patients were studied. Placebo and active treatment groups were well matched at baseline. MgSO(4) had no benefit with regards hospital admission rates or % predicted PEF at 60 min (p=0.48) for the whole group, or for subgroups of life-threatening (p=0.85), severe (p=0.63) and moderate (p=0.67) acute asthma.

CONCLUSION

This study did not show additional benefit from 1.2g IV MgSO(4) when given as an adjunct to standard therapy for acute asthma.

摘要

背景

急性哮喘的治疗基于支气管痉挛和气道炎症的快速逆转。硫酸镁（MgSO₄）已知对平滑肌有支气管扩张作用，但尽管在国家和国际指南中推荐使用，但其在急性哮喘中的疗效研究结果相互矛盾。

目的

确定静脉注射MgSO₄作为标准治疗的辅助手段时，是否能改善急性哮喘的治疗效果。

方法

一项双盲、随机、安慰剂对照试验，比较1.2g MgSO₄与标准治疗对成年急性哮喘患者的疗效。患者的呼气峰流速（PEF）≤预测值的75%，所有患者均接受吸氧、雾化沙丁胺醇和异丙托溴铵以及静脉注射氢化可的松治疗。然后他们接受1.2g静脉注射MgSO₄或安慰剂。观察指标为60分钟时预测PEF的百分比和住院率。