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左沙丁胺醇与消旋沙丁胺醇治疗哮喘急性发作的比较。

Levosalbutamol vs racemic salbutamol in the treatment of acute exacerbation of asthma.

机构信息

Department of Pediatrics, Subharti Institute of Medical Sciences, Meerut, U.P., India.

出版信息

Indian J Pediatr. 2009 Nov;76(11):1131-5. doi: 10.1007/s12098-009-0245-4.

Abstract

OBJECTIVE

To compare efficacy and tolerability of levosalbutamol (Group 1) and racemic salbutamol (Group 2) for the treatment of acute exacerbation of asthma in children age 5 to 18 yr.

METHODS

A randomized double blind clinical study involving 60 children was undertaken between October' 06 to December' 07.

RESULTS

The following baseline clinical characteristic were recorded initially and after giving 3 nebulizations at 20 min intervals in the Ist hour of presentation viz respiratory rate (RR), heart rate (HR), oxygen saturation in room air SPO2, PEFR (peak expiratory flow rate), serum K+ level and asthma score. In Group 1 patients (levosalbutamol), there was significant increment in SPO2 and PEFR (P<0.05) values with decrease in tachypnea and asthma score while no significant difference was found in pre and post treatment HR & Serum K+ levels. In Group 2 patients although there was clinical improvement in terms of SPO2, PEFR, RR and asthma score, it resulted in significant tachycardia and decrease in K+ levels.

CONCLUSION

Levosalbutamol appears to be more efficacious than racemic salbutamol in terms of improvement in PEFR, SPO2 and asthma score while deleterious effects of tachycardia and fall in serum K+ were seen with racemic salbutamol.

摘要

目的

比较左沙丁胺醇(第 1 组)和消旋沙丁胺醇(第 2 组)治疗 5 至 18 岁儿童哮喘急性发作的疗效和耐受性。

方法

一项随机、双盲临床研究,纳入了 60 名儿童,研究时间为 2006 年 10 月至 2007 年 12 月。

结果

最初记录了以下基线临床特征,并在首次就诊的第 1 小时内每 20 分钟给予 3 次雾化吸入后再次记录,特征包括呼吸频率(RR)、心率(HR)、室内空气血氧饱和度(SPO2)、呼气峰流速(PEFR)、血清 K+水平和哮喘评分。在第 1 组(左沙丁胺醇)患者中,SPO2 和 PEFR 值显著增加(P<0.05),呼吸急促和哮喘评分降低;而治疗前后 HR 和血清 K+水平无显著差异。在第 2 组患者中,虽然 SPO2、PEFR、RR 和哮喘评分方面有所改善,但导致了显著的心动过速和 K+水平下降。

结论

左沙丁胺醇在改善 PEFR、SPO2 和哮喘评分方面似乎比消旋沙丁胺醇更有效,而消旋沙丁胺醇则会产生心动过速和血清 K+水平下降等有害影响。

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