Gilman M J, Meyer L, Carter J, Slovis C
Division of Pulmonary and Critical Care Medicine, Emory University School of Medicine, Atlanta.
Chest. 1990 Nov;98(5):1095-8. doi: 10.1378/chest.98.5.1095.
The efficacy of nebulized glycopyrrolate compared with metaproterenol was evaluated in 46 patients with acute asthma. In a double-blinded, randomized fashion, patients received, as sole therapy, either 2 mg of glycopyrrolate or 15 mg of metaproterenol every 2 h over a 6-h study period. Of the 35 patients completing the study, analysis of variance demonstrated no difference in percentage of change in FEV1 between glycopyrrolate and metaproterenol. Two hours after the initial dose, there was a 30 percent increase in FEV1 for glycopyrrolate compared with a 25 percent increase for metaproterenol (p greater than 0.05, NS). In contrast to the comparable bronchodilator activity, the side effects profile of the two agents were markedly dissimilar. Not only were subjective complaints of tremor, palpitations, and paresthesias increased for metaproterenol, but the heart rate response was significantly elevated (p less than 0.05) compared with glycopyrrolate. Based on these data, administration of the aerosolized anticholinergic agent, glycopyrrolate, is a reasonable therapeutic alternative for acute asthma.
在46例急性哮喘患者中评估了雾化吸入格隆溴铵与间羟异丙肾上腺素的疗效。在双盲、随机的方式下，患者在6小时的研究期间内每2小时接受一次单一治疗，即2毫克格隆溴铵或15毫克间羟异丙肾上腺素。在完成研究的35例患者中，方差分析表明格隆溴铵和间羟异丙肾上腺素之间FEV1变化百分比无差异。初始剂量后两小时，格隆溴铵组FEV1增加30%，而间羟异丙肾上腺素组增加25%（p>0.05，无统计学意义）。与相当的支气管扩张活性相反，两种药物的副作用情况明显不同。间羟异丙肾上腺素不仅震颤、心悸和感觉异常的主观主诉增加，而且与格隆溴铵相比，心率反应显著升高（p<0.05）。基于这些数据，雾化吸入抗胆碱能药物格隆溴铵是急性哮喘的一种合理治疗选择。
