Sharp J T
J Allergy Clin Immunol. 1986 Oct;78(4 Pt 2):800-5. doi: 10.1016/0091-6749(86)90064-3.
Although prolonged use of maintenance theophylline therapy in chronic obstructive lung disease remains controversial, evidence from well-designed studies indicates that it produces patient improvement as gauged by both objective and subjective measurements. An important reason to use sustained-release theophylline is to prevent episodes of bronchospasm by providing a smooth around-the-clock bronchodilator effect and thus reducing the need for periodic aerosolized beta agonists. Theophylline also increases diaphragmatic contractility and endurance, although there is disagreement concerning the practical clinical significance of this effect. The drug improves cardiovascular function by increasing myocardial contractility and by reducing pulmonary and systemic vascular resistances. The increased central respiratory drive produced by theophylline may be important in reducing the ventilatory depressant effects of oxygen therapy. The drug also acts to inhibit mediator release and improves several aspects of mucociliary function, although, again, the clinical significance of these actions has not been established.
尽管长期使用维持剂量的茶碱治疗慢性阻塞性肺疾病仍存在争议，但精心设计的研究证据表明，通过客观和主观测量评估，它能使患者病情得到改善。使用缓释茶碱的一个重要原因是通过提供持续的全天候支气管扩张作用来预防支气管痉挛发作，从而减少对周期性雾化β受体激动剂的需求。茶碱还能增强膈肌收缩力和耐力，尽管对于这种作用的实际临床意义存在分歧。该药物通过增强心肌收缩力以及降低肺血管和体循环血管阻力来改善心血管功能。茶碱产生的增强的中枢呼吸驱动可能对减轻氧疗的通气抑制作用很重要。该药物还能抑制介质释放并改善黏液纤毛功能的多个方面，不过同样，这些作用的临床意义尚未确定。
