Rochat Thierry, Janssens Jean-Paul
Service de pneumologie, HUG, 1211 Genève 14.
Rev Med Suisse. 2009 Jan 14;5(186):135-7.
In 2008, studies on inhaled anticholinergic bronchodilators for chronic obstructive pulmonary disease (COPD) were published, some of them with contradictory messages. One study, and a meta-analysis suggested that inhaled ipratropium on the long- term is associated with increased risk for cardiac death. Therefore some caution should be at place when prescribing this drug in patients with coronary or rhythmic cardiac disease. On the other hand, a large randomized, placebo-controlled study on tiotropium did not suggested increased adverse cardio-vascular effects, but rather a diminution, and showed beneficial bronchodilator effect in patients with COPD. However the treatment did not attenuate the annual decline of lung function, and did not decrease mortality in these patients.
2008年，有关吸入性抗胆碱能支气管扩张剂用于慢性阻塞性肺疾病（COPD）的研究发表了，其中一些研究传递出相互矛盾的信息。一项研究及一项荟萃分析表明，长期吸入异丙托溴铵与心脏死亡风险增加有关。因此，在为患有冠状动脉疾病或心律失常性心脏病的患者开具此药时应谨慎。另一方面，一项关于噻托溴铵的大型随机、安慰剂对照研究并未表明心血管不良影响增加，反而显示有所减少，且在COPD患者中显示出有益的支气管扩张作用。然而，该治疗并未减缓肺功能的年度下降，也未降低这些患者的死亡率。
