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静脉注射茶碱对囊性纤维化患者的支气管扩张作用:一项双盲安慰剂对照交叉临床试验的结果

Bronchodilation from intravenous theophylline in patients with cystic fibrosis: results of a blinded placebo-controlled crossover clinical trial.

作者信息

Pan S H, Canafax D M, Le C T, Cipolle R J, Uden D L, Warwick W J

机构信息

Department of Pharmacy Practice, University of Minnesota, Minneapolis 55455.

出版信息

Pediatr Pulmonol. 1989;6(3):172-9. doi: 10.1002/ppul.1950060309.

Abstract

Most patients with cystic fibrosis (CF) eventually develop chronic obstructive pulmonary disease and theoretically could benefit from theophylline therapy. The purpose of this study was to investigate the pharmacologic response to intravenous theophylline by pulmonary function tests (PFT) and the theophylline pharmacokinetics in patients with CF. A randomized, double-blind, placebo-controlled, crossover trial was conducted in 10 ambulant patients with CF (5 females, 5 males), aged 11 to 21 years. Each patient received an intravenous dose of theophylline and normal saline over 1/2 hour on consecutive days. Spirometry and whole-body plethysmography were performed at baseline, 1, 3, 5, and 7 h after the theophylline dose, and 10 blood samples were collected over 9 h on both study days. The percent change of PFT from the baseline was recorded. Analysis of variance for balanced two-period crossover design was used to evaluate the effectiveness of theophylline therapy. The serum concentration (Conc.) vs. time data were fitted using nonlinear least-squares regression analysis. The theophylline dose administered was 7.9 +/- 0.4 (mean +/- SD) mg/kg, which produced a maximal Conc. (Cmax) of 14.6 +/- 2.7 microgram/ml. The half-life (T1/2), volume of distribution (Vd), and total body clearance (TBC) were 4.9 +/- 1.9 h, 537 +/- 124 mL/kg, and 80 +/- 16 ml/h/kg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

大多数囊性纤维化(CF)患者最终会发展为慢性阻塞性肺疾病,理论上可从茶碱治疗中获益。本研究的目的是通过肺功能测试(PFT)及CF患者的茶碱药代动力学来研究静脉注射茶碱的药理反应。对10名年龄在11至21岁的CF门诊患者(5名女性,5名男性)进行了一项随机、双盲、安慰剂对照的交叉试验。每位患者连续两天在半小时内静脉注射一剂茶碱和生理盐水。在茶碱给药后的基线、1、3、5和7小时进行肺活量测定和全身体积描记法,并在两个研究日的9小时内采集10份血样。记录PFT相对于基线的变化百分比。采用两期交叉设计的方差分析来评估茶碱治疗的有效性。血清浓度(Conc.)与时间数据采用非线性最小二乘回归分析进行拟合。给予的茶碱剂量为7.9±0.4(平均±标准差)mg/kg,产生的最大浓度(Cmax)为14.6±2.7微克/毫升。半衰期(T1/2)、分布容积(Vd)和全身清除率(TBC)分别为4.9±1.9小时、537±124毫升/千克和80±16毫升/小时/千克。(摘要截于250字)

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