Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Respirology. 2011 Jan;16(1):161-6. doi: 10.1111/j.1440-1843.2010.01894.x.
Dry powder mannitol has the potential to be used to enhance clearance of mucus in subjects with bronchiectasis. A reduction in FEV1 has been recorded in some subjects with bronchiectasis after inhaling mannitol. The aim of this study was to investigate if pre-medicating with either sodium cromoglycate (SCG) or eformoterol could inhibit this reduction in FEV1.
A double-blind, placebo-controlled, randomized cross-over study was conducted. Lung function and airway response to mannitol was assessed on a control day and then re-assessed after pre-medication with placebo, SCG and eformoterol in nine subjects. Sensitivity to mannitol, expressed as the dose required to induce a 15% fall in FEV1 (PD15), and reactivity to mannitol, expressed as the % fall in FEV1 per mg of mannitol (response-dose ratio, RDR), are reported.
Subjects had an FEV1 of 68 ± 14% predicted, FVC of 97 ± 15% predicted and FEV1 /FVC of 71 ± 8%. They were mildly hypoxemic and the SpO2 was 95 ± 2%.They had a PD15 to mannitol of 235 mg (95% CI: 150-368 mg) and a RDR of 0.057% fall in FEV1 per mg (95% CI: 0.038-0.085). After pre-medication with SCG, PD15 increased (773 mg, P < 0.05) and RDR was reduced (0.013, P < 0.05). Pre-medication with eformoterol also resulted in an increased PD15 (1141 mg, P < 0.01) and a reduced RDR (0.009, P < 0.01). A small but significant decrease in SpO2 from baseline was noted after mannitol in the presence of SCG (P < 0.05).
Pre-medication with either SCG or eformoterol protects patients with bronchiectasis from developing a significant reduction in FEV1 after inhaling mannitol.
干粉甘露醇有可能被用于增强支气管扩张症患者的黏液清除能力。一些支气管扩张症患者在吸入甘露醇后，FEV1 会下降。本研究旨在探究预先使用色甘酸钠（SCG）或福莫特罗是否能抑制这种 FEV1 下降。
这是一项双盲、安慰剂对照、随机交叉研究。在对照日评估肺功能和气道对甘露醇的反应，然后在 9 名受试者中分别进行安慰剂、SCG 和福莫特罗预处理后，再次评估这些指标。FEV1 下降 15%所需的甘露醇剂量（PD15）和每毫克甘露醇引起的 FEV1 下降百分比（反应剂量比，RDR）用于表示甘露醇的敏感性和反应性。
受试者的 FEV1 为预测值的 68±14%，FVC 为预测值的 97±15%，FEV1/FVC 为 71±8%。他们存在轻度低氧血症，SpO2 为 95±2%。他们的 PD15 为 235mg（95%CI：150-368mg），RDR 为 0.057%FEV1 下降/mg（95%CI：0.038-0.085）。在使用 SCG 预处理后，PD15 增加（773mg，P<0.05），RDR 降低（0.013，P<0.05）。福莫特罗预处理也导致 PD15 增加（1141mg，P<0.01）和 RDR 降低（0.009，P<0.01）。在使用 SCG 时，吸入甘露醇后，SpO2 从基线水平略有但显著下降（P<0.05）。
预先使用 SCG 或福莫特罗可保护支气管扩张症患者在吸入甘露醇后不会出现 FEV1 显著下降。
