Nelson M S, Hofstadter A, Parker J, Hargis C
Division of Emergency Medicine, Department of Surgery, Stanford University School of Medicine, California 94305-5239.
Ann Emerg Med. 1990 Jan;19(1):21-5. doi: 10.1016/s0196-0644(05)82134-1.
Acute asthma exacerbations are common complaints in patients who present to the emergency department. A prospective, double-blinded study was designed to evaluate how frequency of dosing of an inhaled beta-agonist, metaproterenol (Alupent inhalation solution) would affect patient response, length of stay in the ED, and admission rates. Forty-one patients initially received a 0.3-mL dose of nebulized metaproterenol followed by two additional doses of either metaproterenol or saline every 20 minutes. While there was no difference in response (forced expiratory volume in one second) in patients at 30 minutes after their arrival, there was an improved response in the metaproterenol group at 60 and 120 minutes. The length of stay in the ED was approximately the same for both groups. There was no significant difference in admission rates. No increase in undesirable side effects (eg, nausea, tremor, palpitations) was seen in the metaproterenol-treated group. Frequent dosing of metaproterenol is useful in asthmatics having acute exacerbations and leads to rapid improvement without an increase in toxicity.
急性哮喘加重是急诊科患者的常见主诉。一项前瞻性双盲研究旨在评估吸入型β受体激动剂间羟异丙肾上腺素（Alupent吸入溶液）的给药频率如何影响患者反应、在急诊科的住院时间和住院率。41名患者最初接受了0.3毫升雾化吸入的间羟异丙肾上腺素剂量，随后每20分钟额外接受两剂间羟异丙肾上腺素或生理盐水。虽然患者到达后30分钟时反应（一秒用力呼气量）没有差异，但间羟异丙肾上腺素组在60分钟和120分钟时反应有所改善。两组在急诊科的住院时间大致相同。住院率没有显著差异。间羟异丙肾上腺素治疗组未观察到不良副作用（如恶心、震颤、心悸）增加。频繁给予间羟异丙肾上腺素对急性加重的哮喘患者有用，可导致快速改善且不增加毒性。
