肾上腺素与夜间哮喘。
Adrenaline and nocturnal asthma.
作者信息
Morrison J F, Teale C, Pearson S B, Marshall P, Dwyer N M, Jones S, Dean H G
机构信息
Pulmonary Function Laboratory, Killingbeck Hospital, Leeds.
出版信息
BMJ. 1990 Sep 8;301(6750):473-6. doi: 10.1136/bmj.301.6750.473.
OBJECTIVE
To determine whether the nocturnal fall in plasma adrenaline is a cause of nocturnal asthma.
DESIGN
Double blind placebo controlled cross-over study. In the first experiment the nocturnal fall in plasma adrenaline at 4 am was corrected in 10 asthmatic subjects with an infusion of adrenaline after parasympathetic blockade with 30 micrograms/kg intravenous atropine. In the second experiment 11 asthmatic subjects showing similar variations in peak expiratory flow rate had the nocturnal fall in plasma adrenaline corrected by infusion before atropine was given.
PATIENTS
Asthmatic subjects with a diurnal variation in home peak expiratory flow rate of greater than 20% for at least 75% of the time in the two weeks before the study.
MAIN OUTCOME MEASURES
Peak expiratory flow rate and plasma adrenaline.
RESULTS
Correction of the nocturnal fall in plasma adrenaline at 4 am to resting 4 pm levels did not alter peak expiratory flow rate either before or after parasympathetic blockade with atropine.
CONCLUSION
A nighttime fall in plasma adrenaline is not a cause of nocturnal asthma.
目的
确定血浆肾上腺素夜间下降是否为夜间哮喘的病因。
设计
双盲安慰剂对照交叉研究。在第一个实验中，10名哮喘患者在静脉注射30微克/千克阿托品进行副交感神经阻滞后，通过输注肾上腺素纠正凌晨4点时血浆肾上腺素的夜间下降。在第二个实验中，11名呼气峰值流速有类似变化的哮喘患者在给予阿托品之前，通过输注纠正血浆肾上腺素的夜间下降。
患者
在研究前两周内，至少75%的时间里，家庭呼气峰值流速日间变化大于20%的哮喘患者。
主要观察指标
呼气峰值流速和血浆肾上腺素。
结果
将凌晨4点时血浆肾上腺素的夜间下降纠正至下午4点的静息水平，在用阿托品进行副交感神经阻滞之前或之后，均未改变呼气峰值流速。
结论
血浆肾上腺素夜间下降不是夜间哮喘的病因。
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