Owens M W, George R B
Department of Medicine, Louisiana State University Medical Center, Shreveport 71130.
Chest. 1991 May;99(5):1084-7. doi: 10.1378/chest.99.5.1084.
Conflicting reports have appeared concerning the role of anticholinergic agents in the treatment of acute asthma. This study was designed to determine whether atropine sulfate, the only anticholinergic agent currently available in the United States for nebulization, increases bronchodilation when added to an inhaled beta-adrenergic agonist during the initial treatment of an acute asthma attack. Adults asthmatics (n = 40) with acute asthma attacks were randomized to receive metaproterenol (5 percent solution, 0.3 ml) either alone or with atropine sulfate (2.5 mg), by nebulization. Spirometry, vital signs, and the presence of side effects 0, 30, 60, and 120 minutes after treatment were determined. There were no significant differences between the metaproterenol alone and metaproterenol plus atropine sulfate groups in regard to age, duration of asthma, baseline spirometry, or side effects. No differences were noted between the two groups regarding changes in FEV1 and FVC from baseline (expressed in milliliters or as a percentage of baseline) during the observation period. We conclude that nebulized atropine sulfate yields no additional benefit when added to metaproterenol during the initial treatment of an acute asthma attack.
关于抗胆碱能药物在急性哮喘治疗中的作用，出现了相互矛盾的报道。本研究旨在确定硫酸阿托品（美国目前唯一可用于雾化的抗胆碱能药物）在急性哮喘发作的初始治疗中，添加到吸入型β-肾上腺素能激动剂中时是否能增强支气管扩张作用。患有急性哮喘发作的成年哮喘患者（n = 40）被随机分为两组，分别通过雾化吸入单独使用间羟异丙肾上腺素（5%溶液，0.3 ml）或与硫酸阿托品（2.5 mg）联合使用。在治疗后0、30、60和120分钟测定肺活量、生命体征以及副作用的出现情况。单独使用间羟异丙肾上腺素组和间羟异丙肾上腺素加硫酸阿托品组在年龄、哮喘病程、基线肺活量或副作用方面无显著差异。在观察期内，两组在FEV1和FVC相对于基线的变化（以毫升表示或以基线的百分比表示）方面未发现差异。我们得出结论，在急性哮喘发作的初始治疗中，将硫酸阿托品雾化添加到间羟异丙肾上腺素中不会带来额外益处。
