噻托溴铵联合福莫特罗可改善 COPD 患者运动后的吸气肌力量。

Addition of tiotropium to formoterol improves inspiratory muscle strength after exercise in COPD.

机构信息

Exercise Biochemistry and Physiology Laboratory, Postgraduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, Brazil.

出版信息

Respir Med. 2012 Oct;106(10):1404-12. doi: 10.1016/j.rmed.2012.05.012. Epub 2012 Jun 28.

DOI:10.1016/j.rmed.2012.05.012

PMID:22748747

Abstract

BACKGROUND

The addition of tiotropium bromide (TIO) to formoterol fumarate (FOR) improves exercise performance in patients with chronic obstructive pulmonary disease (COPD). In this study, we test the hypothesis that the addition of TIO to FOR may improve respiratory muscle performance and oxygen uptake kinetics after exercise in patients with COPD.

METHODS

Thirty eight patients with COPD were randomized to a 2 week treatment with FOR 12 μg twice a day plus TIO 18 μg once a day (FOR + TIO) or FOR 12 μg twice a day plus placebo (FOR + PLA) once a day, using a double-blind crossover design. Inspiratory muscle. Strength was measured before, immediately after, as well as 2, 5, and 10 min during recovery of exercise. Time to limit of tolerance on a constant work load exercise test and oxygen uptake kinetics during recovery were evaluated before and after intervention.

RESULTS

Only FOR + TIO improved resting (63 ± 10 cm to 84 ± 11 cmH(2)O) and post-exercise (49 ± 7 cm to 84 ± 11 cmH(2)O) maximal inspiratory pressure. Time to limit of tolerance on the constant work load test was increased by FOR + PLA and by FOR + TIO, but the size of the increment was significantly larger with FOR + TIO (40.7 ± 7.6% vs. 84.5 ± 8.2%; p < 0.05). Only FOR + TIO improved oxygen uptake kinetics during recovery (69 ± 21 to 60 ± 18 s). The improvement in maximal inspiratory pressure (0.78, p < 0.001) and in oxygen uptake kinetics (-0.91, p < 0.001) correlated with the change in time to the limit of tolerance.

CONCLUSIONS

The addition of TIO to FOR improves inspiratory muscle strength and oxygen uptake kinetics after exercise in COPD patients.

摘要

背景

噻托溴铵（TIO）联合富马酸福莫特罗（FOR）可改善慢性阻塞性肺疾病（COPD）患者的运动表现。在这项研究中，我们验证了这样一个假设，即 TIO 联合 FOR 可改善 COPD 患者运动后呼吸肌功能和摄氧量动力学。

方法

38 例 COPD 患者采用双盲交叉设计随机分为两组，分别接受为期 2 周的治疗：每日 2 次 FOR12μg+TIO18μg（FOR+TIO）或每日 1 次 FOR12μg+安慰剂（FOR+PLA）。在运动前、运动即刻、运动后 2、5 和 10 分钟时测量吸气肌力量。在干预前后评估恒功率运动试验的耐力限制时间和恢复期的摄氧量动力学。

结果

仅 FOR+TIO 改善了静息（63±10cmH2O 至 84±11cmH2O）和运动后（49±7cmH2O 至 84±11cmH2O）的最大吸气压力。FOR+PLA 和 FOR+TIO 均可延长恒功率运动试验的耐力限制时间，但 FOR+TIO 时的延长幅度明显更大（40.7±7.6%比 84.5±8.2%；p<0.05）。仅 FOR+TIO 改善了恢复期的摄氧量动力学（69±21 秒至 60±18 秒）。最大吸气压力的改善（0.78，p<0.001）和摄氧量动力学的改善（-0.91，p<0.001）与耐力限制时间的变化相关。