Campbell I A, Middleton W G, McHardy G J, Shotter M V, McKenzie R, Kay A B
Thorax. 1977 Aug;32(4):424-8. doi: 10.1136/thx.32.4.424.
, 424-428. Using a factorially designed study, 38 patients with bronchial asthma received a single dose of either isoprenaline by inhalation (9), aminophylline intravenously (10), isoprenaline and aminophylline (11), or placebo (8). The maximum expiratory flow (V max), the maximum expiratory flow at 50% of vital capacity (V max), and the concentrations of plasma cyclic AMP were measured at time intervals up to two hours. The combination of isoprenaline and aminophylline acted synergistically in terms of the percent increase in V max. However, this was statistically significant only at 20 minutes. Plasma cyclic AMP concentration rose with a similar time course of response to the changes in small airways. The elevations in plasma cyclic AMP observed with the drug combination were higher than those for the individual drugs at 10, 20, 30, and 60 minutes but these differences were not statistically significant. These observations support the concept that changes in bronchial smooth muscle tone are mediated by concentrations of cyclic nucleotides and that combinations of isoprenaline and aminophylline, rather than the administration of each drug separately, may have therapeutic advantages in the treatment of bronchial asthma.
424 - 428。采用析因设计研究，38例支气管哮喘患者分别接受单次吸入异丙肾上腺素（9例）、静脉注射氨茶碱（10例）、异丙肾上腺素与氨茶碱联合使用（11例）或安慰剂（8例）治疗。在长达两小时的时间间隔内测量最大呼气流量（V max）、肺活量50%时的最大呼气流量（V 50max）以及血浆环磷酸腺苷浓度。就V max的增加百分比而言，异丙肾上腺素与氨茶碱联合使用具有协同作用。然而，这仅在20分钟时具有统计学意义。血浆环磷酸腺苷浓度随小气道变化的反应具有相似的时间进程。在10、20、30和60分钟时，联合用药观察到的血浆环磷酸腺苷升高高于各单一药物，但这些差异无统计学意义。这些观察结果支持以下概念：支气管平滑肌张力的变化由环核苷酸浓度介导，并且异丙肾上腺素与氨茶碱联合使用而非单独使用每种药物在支气管哮喘治疗中可能具有治疗优势。
