Caire N, Cartier A, Ghezzo H, L'Archevêque J, Malo J L
Department of Chest Medicine, Hôpital du Sacré-Coeur, Montreal, Canada.
Clin Exp Allergy. 1989 Jan;19(1):65-70. doi: 10.1111/j.1365-2222.1989.tb02346.x.
It has been hypothesized that bronchoconstriction due to exercise and hyperventilation is caused by the stimulation of irritant receptors in the upper airways. However, controversial results have been reported on the effect of lignocaine, which can inhibit the stimulation of these receptors. The aim of this study was to investigate the effect of inhaled lignocaine on bronchial responsiveness to hyperventilation of cold dry air in asthmatic subjects. Eight adult asthmatic subjects in a clinical steady state came on four different days (two placebo and two active days in random order) with a maximum interval of 3 weeks. After assessment of forced expiratory flow rates, inhalation of either phosphate-buffered saline (placebo) or lignocaine solution (40 mg) was carried out in a single-blind fashion. The technician was not aware which medication was being inhaled, but the asthmatic subject knew which drug it was by the sensation in his or her throat. Forced expiratory flow rates were reassessed 15 min after the nebulization; then, the subjects were asked to inhale cold dry air (-20 degrees C) in progressively increasing levels of ventilation (7.5, 15, 30 and 60 l/min and maximum voluntary ventilation). PD20 was interpolated from the dose-response curve, relating the dose of cold air on a non-cumulative logarithmic scale on the abscissa and the percentage change in FEV1 on the ordinate. There were no significant changes in FEV1 and PD20 after inhalation of lignocaine as compared to the placebo. We conclude that inhaled lignocaine does not significantly alter bronchial hyperresponsiveness to hyperventilation of cold air in asthmatic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
据推测,运动和过度通气引起的支气管收缩是由上呼吸道刺激性感受器受刺激所致。然而,关于可抑制这些感受器受刺激的利多卡因的作用,已有相互矛盾的研究结果报道。本研究旨在调查吸入利多卡因对哮喘患者支气管对冷干空气过度通气反应性的影响。8名处于临床稳定状态的成年哮喘患者在4个不同日期前来就诊(随机顺序为2个安慰剂日和2个活性药物日),最大间隔为3周。在评估用力呼气流量后,以单盲方式吸入磷酸缓冲盐水(安慰剂)或利多卡因溶液(40mg)。技术员不知道吸入的是哪种药物,但哮喘患者通过喉咙的感觉知道是哪种药物。雾化15分钟后重新评估用力呼气流量;然后,要求受试者以逐渐增加的通气水平(7.5、15、30和60l/min以及最大自主通气量)吸入冷干空气(-20℃)。从剂量反应曲线内插出PD20,横坐标为非累积对数尺度的冷空气剂量,纵坐标为FEV1的百分比变化。与安慰剂相比,吸入利多卡因后FEV1和PD20无显著变化。我们得出结论,吸入利多卡因不会显著改变哮喘患者支气管对冷空气过度通气的高反应性。(摘要截短于250字)