Respiratory Diseases Unit and School of Specialization in Respiratory Diseases Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2017 Jun;21(11):2708-2716.
We have measured peak inspiratory flow (PIF), inspiratory capacity (IC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and other functional parameters in COPD patients to investigate which PIF's patients generate with maximal effort, through three different resistances, representing Diskus, Nexthaler and Turbuhaler.
Forty patients with COPD were enrolled in this study. All patients were examined: pulmonary function tests, including flow/volume spirometry and N2-wash out, were conducted. MIP and MEP were measured. PIF was measured using the In-check DIAL; patients inhaled through the device set for the optimal Turbuhaler resistance, Nexthaler resistance and Diskus resistance. The relationship between lung function parameters and PIF was studied.
The mean PIF through Nexthaler resistance was significantly higher than the Turbohaler resistance. We have found a mild correlation between PIF and MIP and between PIF, IC and VC.
All patients could achieve inspiratory flows > 30 l/min with all inhalers used for the trial. The most interesting result is the mild correlation between MIP and PIF, showing that inspiratory muscle force is probably an important predictor of an adequate inspiratory flow in COPD patients. Many studies confirmed that when using a DPI the inhalation flow is dependent on the resistance of the device and the patient's inspiratory effort.
Inhalation therapy is the mainstay of treatment of patients with COPD. In the last years, significant developments have been achieved in the field of device formulation, but in daily practice, an appropriate inhaler choice should consider not only device related aspects, but also patient's pulmonary function and in particular patient's respiratory muscle strength.
我们测量了 COPD 患者的吸气峰流速（PIF）、吸气量（IC）、最大吸气压力（MIP）、最大呼气压力（MEP）和其他功能参数，以研究通过三种不同阻力（代表 Diskus、Nexthaler 和 Turbuhaler），患者在最大努力下产生的最大吸气峰流速。
本研究纳入了 40 名 COPD 患者。所有患者均接受了检查：肺功能测试，包括流量/容积肺活量测定和 N2 洗脱；进行了 MIP 和 MEP 测量。使用 In-check DIAL 测量 PIF；患者通过设置最佳 Turbuhaler 阻力、Nexthaler 阻力和 Diskus 阻力的设备进行吸气。研究了肺功能参数与 PIF 之间的关系。
通过 Nexthaler 阻力的平均 PIF 明显高于 Turbohaler 阻力。我们发现 PIF 与 MIP 之间以及 PIF、IC 和 VC 之间存在轻度相关性。
所有患者均能通过用于试验的所有吸入器达到 > 30 l/min 的吸气流量。最有趣的结果是 MIP 和 PIF 之间存在轻度相关性，表明吸气肌力量可能是 COPD 患者足够吸气流量的重要预测因素。许多研究证实，使用 DPI 时，吸入流量取决于设备的阻力和患者的吸气努力。
吸入疗法是 COPD 患者治疗的主要手段。在过去几年中，设备制剂领域取得了重大进展，但在日常实践中，适当的吸入器选择不仅应考虑设备相关方面，还应考虑患者的肺功能，特别是患者的呼吸肌力量。
