Department of Pulmonology, IJsselland Ziekenhuis, Capelle a/d IJssel, The Netherlands.
Respir Physiol Neurobiol. 2010 Aug 31;173(1):58-63. doi: 10.1016/j.resp.2010.06.007. Epub 2010 Jun 18.
The responsiveness of short-term bronchodilator use on inspiratory lung function parameters (ILPs), including Forced Inspiratory Volume in one second (FIV(1)), Inspiratory Capacity (IC), Forced Inspiratory Flow at 50% of the vital capacity (FIF(50)), Peak Inspiratory Flow (PIF) and on the relationship between these values and dyspnea in COPD subjects has been examined only sparsely in past studies. The aim of this study was to assess the effects of inhaled salbutamol 400 mcg, ipratropium 80 mcg and a placebo on ILP and FEV(1) and their relationship to dyspnea, as measured with a Visual Analogue Scale (VAS).
A total of 85 subjects with stable COPD participated in a crossover, randomized, double-blind, placebo-controlled study. Spirometry was performed before and after inhalation of salbutamol, ipratropium or a placebo. The primary analysis was performed using 63 participants with absent reversibility.
All ILP and FEV(1) values improved significantly after bronchodilator administration except for FIF(50) after ipratropium administration. After administration of both bronchodilators, the mean percent changes from initial values did not significantly differ between the various ILPs and FEV(1). The mean VAS score showed significant improvements after bronchodilator and placebo inhalation but did not significantly correlate with changes in lung function parameters. For each lung function parameter, patients were further classified as responders if the amount of change was greater than the coefficient of repeatability of the test. Response rates did not differ significantly between the various ILPs. Moreover, no significant differences were found between responders and non-responders with respect to dyspnea after bronchodilator inhalation. This finding applied to all ILP and FEV(1) values.
In subjects with COPD, all ILP, FEV(1) values and VAS scores showed significant improvements after bronchodilator use as well as with placebo. However, ILPs were not more sensitive than FEV(1) for detecting responders after bronchodilator use or changes in the VAS score.
短期支气管扩张剂使用对吸气肺功能参数（ILP）的反应性，包括 1 秒用力呼气量（FIV（1））、吸气量（IC）、肺活量 50%时的吸气流量（FIF（50））、吸气峰流速（PIF）以及这些值与 COPD 患者呼吸困难之间的关系，在过去的研究中仅得到了有限的研究。本研究的目的是评估吸入沙丁胺醇 400 mcg、异丙托溴铵 80 mcg 和安慰剂对 ILP 和 FEV（1）的影响，以及它们与呼吸困难的关系，呼吸困难通过视觉模拟量表（VAS）进行评估。
共有 85 名稳定期 COPD 患者参与了一项交叉、随机、双盲、安慰剂对照研究。吸入沙丁胺醇、异丙托溴铵或安慰剂前后进行肺量测定。主要分析使用 63 名无逆转性患者进行。
除异丙托溴铵给药后 FIF（50）外，所有 ILP 和 FEV（1）值均显著改善。两种支气管扩张剂给药后，各 ILP 和 FEV（1）的初始值的平均百分比变化无显著差异。支气管扩张剂和安慰剂吸入后平均 VAS 评分均显著改善，但与肺功能参数的变化无显著相关性。对于每个肺功能参数，如果变化量大于测试的重复性系数，则患者进一步分为反应者。各 ILP 的反应率无显著差异。此外，在支气管扩张剂吸入后，与呼吸困难无关的患者之间，在 ILP 之间未发现显著差异。这一发现适用于所有 ILP 和 FEV（1）值。
在 COPD 患者中，支气管扩张剂使用后以及安慰剂吸入后，所有 ILP、FEV（1）值和 VAS 评分均显著改善。然而，与 FEV（1）相比，ILP 并不能更敏感地检测到支气管扩张剂使用后的反应者或 VAS 评分的变化。
