Engel T, Heinig J H, Madsen F, Nikander K
Allergy Unit 7511, Medical Dept TTA, Rigshospitalet, Copenhagen, Denmark.
Eur Respir J. 1990 Oct;3(9):1037-41.
In 101 asthmatic adults with varying degrees of bronchial obstruction, lung function tests including peak inspiratory flow (PIF), inspiratory vital capacity (IVC), peak expiratory flow (PEF), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) measurements were made. Significant correlations between inspiratory and expiratory volumes were found. In most patients, PIF was less reduced than the expiratory parameters of pulmonary function. When inhalation was performed through the new multi-dose, dry-powder inhalation device, Turbuhaler (PIF-TBH), it was significantly lower than PIF measured without Turbuhaler. In previous studies, PIF-TBH of 30 l.min-1 or more has proven sufficient to produce a therapeutic dose of terbutaline, and to produce significant bronchodilatation. Of 101 asthmatics in the present study, only four had PIF-TBH of less than 30 l.min-1. Although no parameters of spirometry could accurately predict PIF-TBH, there was a tendency for patients with severely impaired ventilatory capacity to produce lower PIF-TBH than patients with normal or near-normal ventilatory capacity. If patients with severely impaired ventilatory capacity are to receive inhalation therapy through Turbuhaler, either PIF or PIF-TBH should be measured, or the effect should be carefully monitored.
对101名患有不同程度支气管阻塞的成年哮喘患者进行了肺功能测试,包括测量吸气峰流速(PIF)、吸气肺活量(IVC)、呼气峰流速(PEF)、用力肺活量(FVC)和一秒用力呼气容积(FEV1)。发现吸气量和呼气量之间存在显著相关性。在大多数患者中,PIF的降低程度小于肺功能的呼气参数。当通过新型多剂量干粉吸入装置Turbuhaler进行吸入时(PIF-TBH),其显著低于不使用Turbuhaler测量的PIF。在先前的研究中,已证明30升·分钟-1或更高的PIF-TBH足以产生治疗剂量的特布他林,并产生显著的支气管扩张作用。在本研究的101名哮喘患者中,只有4人的PIF-TBH低于30升·分钟-1。尽管肺量计的参数无法准确预测PIF-TBH,但通气能力严重受损的患者的PIF-TBH往往低于通气能力正常或接近正常的患者。如果通气能力严重受损的患者要通过Turbuhaler接受吸入治疗,应测量PIF或PIF-TBH,或者应仔细监测治疗效果。