Boyd Matt, Blakely Tony, Atkinson June
Department of Public Health University of Otago, Wellington, PO Box 7343, Wellington 6242, New Zealand.
N Z Med J. 2016 Jan 29;129(1429):22-39.
To investigate the effects on lung function of IV magnesium in acute exacerbations of COPD (AECOPD), when given in conjunction with standard bronchodilator therapy.
This was a pilot study to a randomised, double-blinded, placebo-controlled trial. 30 patients presenting to ED with AECOPD were included. In addition to standard bronchodilator therapy, 17 patients were given saline, and 13 received 2 g of magnesium sulphate intravenously. Spirometry was carried out at presentation (TA), after initial standard bronchodilator therapy (TB) and immediately (T0), at 60 minutes (T60) and 120 minutes (T120) after trial drug infusion. Primary outcomes were percentage change in FEV1 and FVC at T0, T60 and T120. Secondary outcomes were admission rates, length of stay and requirement for NIV or mechanical ventilation. Trial registration (ANZCTR), ACTRN12613000837729.
Greater improvements were seen in FEV1 at T0, T60 and T120 compared to TB in magnesium group (at T120, mean percentage change in FEV1 was 27.07% with magnesium versus 11.39% in the placebo group, 95%CI 3.7 to 27.7, p=0.01). Similar significantly greater improvements were noted with FVC in the magnesium group, compared to TB.
IV magnesium sulphate used as an adjunct therapy to standard bronchodilators in AECOPD presenting to ED may improve lung function in the short term.
探讨静脉注射镁剂在慢性阻塞性肺疾病急性加重期（AECOPD）与标准支气管扩张剂联合使用时对肺功能的影响。
这是一项随机、双盲、安慰剂对照试验的初步研究。纳入30例因AECOPD就诊于急诊科的患者。除标准支气管扩张剂治疗外，17例患者给予生理盐水，13例患者静脉注射2g硫酸镁。在就诊时（TA）、初始标准支气管扩张剂治疗后（TB）以及试验药物输注后即刻（T0）、60分钟（T60）和120分钟（T120）进行肺活量测定。主要结局指标为T0、T60和T120时第一秒用力呼气容积（FEV1）和用力肺活量（FVC）的变化百分比。次要结局指标为住院率、住院时间以及无创通气（NIV）或机械通气需求。试验注册（澳大利亚和新西兰临床试验注册中心），注册号：ACTRN12613000837729。
与TB相比，镁剂组在T0、T60和T120时FEV1有更大改善（在T120时，镁剂组FEV1的平均变化百分比为27.07%，而安慰剂组为11.39%，95%置信区间为3.7至27.7，p = 0.01）。与TB相比，镁剂组FVC也有类似的显著更大改善。
在因AECOPD就诊于急诊科的患者中，静脉注射硫酸镁作为标准支气管扩张剂的辅助治疗可能在短期内改善肺功能。
