Cattedra di Malattie dell'Apparato Respiratorio, Università di Brescia, Brescia, Italy.
Int J Chron Obstruct Pulmon Dis. 2011;6:399-405. doi: 10.2147/COPD.S22179. Epub 2011 Jul 12.
Use of short-acting β(2)-agonists in chronic obstructive pulmonary disease (COPD) during treatment with long-acting β(2)-agonists is recommended as needed, but its effectiveness is unclear. The purpose of this study was to assess the additional bronchodilating effect of increasing doses of salbutamol during acute and chronic treatment with formoterol in patients with COPD.
Ten patients with COPD underwent a dose-response curve to salbutamol (until 800 μg of cumulative dose) after a 1-week washout (baseline), 8 hours after the first administration of formoterol 12 μg (day 1), and after a 12-week and 24-week period of treatment with formoterol (12 μg twice daily by dry powder inhaler). Peak expiratory flow, forced expiratory volume in one second (FEV(1)), forced vital capacity, and inspiratory capacity were measured at the different periods of treatment and at different steps of the dose-response curve.
Despite acute or chronic administration of formoterol, maximal values of peak expiratory flow, FEV(1), and forced vital capacity after 800 μg of salbutamol were unchanged compared with baseline. The baseline FEV(1) dose-response curve was steeper than that at day 1, week 12, or week 24 (P < 0.0001). Within each dose-response curve, FEV(1) was different only at baseline and at day 1 (P < 0.001), when FEV(1) was still greater at 800 μg than at 0 μg (P < 0.02). In contrast, the forced vital capacity dose-response curves were similar at the different periods, while within each dose-response curve, forced vital capacity was different in all instances (P < 0.001), always being higher at 800 μg than at 0 μg (P < 0.05).
In patients with stable COPD, the maximal effect of salbutamol on peak expiratory flow, FEV(1), and forced vital capacity was unchanged after either acute or chronic treatment with formoterol. With increasing doses of salbutamol, FEV(1) increased only after acute administration of formoterol. Forced vital capacity also significantly improved during long-term treatment with formoterol.
在使用长效β2-激动剂治疗慢性阻塞性肺病（COPD）期间，推荐按需使用短效β2-激动剂，但其疗效尚不清楚。本研究的目的是评估沙丁胺醇剂量递增对 COPD 患者福莫特罗急性和慢性治疗时的额外支气管扩张作用。
10 例 COPD 患者在 1 周洗脱期（基线）后、福莫特罗首次给药后 8 小时（第 1 天）以及福莫特罗治疗 12 周和 24 周（干粉吸入器，12 μg，每日 2 次）时进行沙丁胺醇剂量反应曲线测定。在不同的治疗阶段和剂量反应曲线的不同步骤时测量呼气峰流速、一秒用力呼气容积（FEV1）、用力肺活量和吸气量。
尽管急性或慢性给予福莫特罗，800 μg 沙丁胺醇后呼气峰流速、FEV1 和用力肺活量的最大值与基线相比无变化。基线 FEV1 剂量反应曲线比第 1 天、第 12 周和第 24 周陡峭（P < 0.0001）。在每个剂量反应曲线内，仅在基线和第 1 天时 FEV1 不同（P < 0.001），此时 800 μg 时的 FEV1 仍大于 0 μg（P < 0.02）。相反，用力肺活量剂量反应曲线在不同阶段相似，而在每个剂量反应曲线内，用力肺活量在所有情况下均不同（P < 0.001），800 μg 时始终大于 0 μg（P < 0.05）。
在稳定的 COPD 患者中，福莫特罗急性或慢性治疗后，沙丁胺醇对呼气峰流速、FEV1 和用力肺活量的最大效应无变化。随着沙丁胺醇剂量的增加，仅在福莫特罗急性给药后 FEV1 增加。在福莫特罗长期治疗期间，用力肺活量也显著改善。
Zotero 插件