Gothe B, Cherniack N S, Bachand R T, Szalkowski M B, Bianco K A
Department of Medicine, Veterans Administration Medical Center, Cleveland, Ohio 44106.
Am J Med. 1988 Mar;84(3 Pt 1):436-44. doi: 10.1016/0002-9343(88)90263-x.
Hypoxemia in patients with chronic obstructive pulmonary disease (COPD) becomes more pronounced during sleep and can result in a number of serious consequences. Almitrine bismesylate is a peripheral chemoreceptor agonist that improves arterial oxygen tension (PaO2) in patients with COPD during wakefulness. Studies conducted for up to six months suggested the agonist may be useful in the management of nocturnal hypoxemia. In this double-blind, parallel, placebo-controlled study, patients with COPD received 50 mg of almitrine bismesylate (n = 9) or placebo (n = 11) twice a day for one year. Almitrine bismesylate increased PaO2 by 8.1 +/- 2.1 mm Hg (mean +/- SEM), decreased arterial carbon dioxide tension by 3.0 +/- 0.7 mm Hg (mean +/- SEM), and increased minute ventilation by 3.1 +/- 0.5 liters/minute (mean +/- SEM) during wakefulness. All of these changes were statistically significant. Five patients in the almitrine bismesylate group and eight patients in the placebo group completed sleep studies prior to and after 56, 180, and 360 days of almitrine bismesylate or placebo administration. Relative to placebo, almitrine bismesylate significantly increased oxygen saturation during sleep without any significant changes in the quantity or quality of sleep.
慢性阻塞性肺疾病（COPD）患者的低氧血症在睡眠期间会更加明显，并可能导致一些严重后果。二甲磺酸烯丙哌三嗪是一种外周化学感受器激动剂，可改善COPD患者清醒时的动脉血氧分压（PaO2）。长达六个月的研究表明，该激动剂可能对治疗夜间低氧血症有用。在这项双盲、平行、安慰剂对照研究中，COPD患者每天两次接受50毫克二甲磺酸烯丙哌三嗪（n = 9）或安慰剂（n = 11）治疗，为期一年。二甲磺酸烯丙哌三嗪在清醒时可使PaO2升高8.1±2.1毫米汞柱（平均值±标准误），使动脉血二氧化碳分压降低3.0±0.7毫米汞柱（平均值±标准误），并使分钟通气量增加3.1±0.5升/分钟（平均值±标准误）。所有这些变化均具有统计学意义。二甲磺酸烯丙哌三嗪组的5名患者和安慰剂组的8名患者在接受二甲磺酸烯丙哌三嗪或安慰剂治疗56、180和360天之前和之后完成了睡眠研究。相对于安慰剂，二甲磺酸烯丙哌三嗪可显著提高睡眠期间的血氧饱和度，而睡眠的数量或质量没有任何显著变化。
