Albazzaz M K, Patel K R, Shakir S, Dargie H J, Reid J M
Department of Respiratory Medicine, Western Infirmary, Glasgow, Scotland.
Am Rev Respir Dis. 1989 Jan;139(1):188-93. doi: 10.1164/ajrccm/139.1.188.
The changes in transcutaneous oxygen saturation (SaO2%) and airway responses to inhaled histamine and leukotriene C4 (LTC4) were examined in 10 asthmatic patients, and the effect of inhaled LTC4 (16 nmol) on cardiopulmonary hemodynamics was examined in seven nonasthmatic patients undergoing diagnostic cardiac catheterization. In asthmatic patients, LTC4 produced oxygen desaturation on two occasions. At a lower dose (2.0 nmol) LTC4 produced a marked fall in SaO2% that lasted less than 15 min and occurred in the absence of significant bronchoconstriction as measured by changes in FEV1, FEF25-75, and SGaw. At a higher cumulative dose (7 nmol), LTC4 caused prolonged oxygen desaturation with slow recovery and this was associated with significant bronchoconstriction. In contrast, histamine inhalation produced a single response with a fall in both FEV1 and SaO2% of short duration. The dose-response characteristics of LTC4 and histamine on oxygen desaturation in asthmatic patients appear to differ significantly and probably are dependent on relative sensitivities of pulmonary vascular and bronchial smooth muscle to these agonists. A single inhaled dose of LTC4 in nonasthmatic subjects produced a marked drop in PaO2 with significant increase in AaPO2, and this was associated with a mean (SEM) decrease in FEV1 of 14% (2.5) from the baseline. The mean cardiac output fell by 15% (3.4) without significant changes in blood pressure and heart rate. There was no electrocardiographic evidence of myocardial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
对10例哮喘患者进行了经皮血氧饱和度(SaO2%)变化以及气道对吸入组胺和白三烯C4(LTC4)反应的研究,并对7例接受诊断性心导管检查的非哮喘患者进行了吸入LTC4(16 nmol)对心肺血流动力学影响的研究。在哮喘患者中,LTC4有两次引起了氧饱和度下降。较低剂量(2.0 nmol)的LTC4使SaO2%显著下降,持续时间不到15分钟,且在以FEV1、FEF25 - 75和比气道传导率(SGaw)变化衡量的无明显支气管收缩的情况下发生。较高累积剂量(7 nmol)时,LTC4导致氧饱和度下降时间延长且恢复缓慢,这与明显的支气管收缩有关。相比之下,吸入组胺产生单一反应,FEV1和SaO2%均短暂下降。哮喘患者中LTC4和组胺对氧饱和度下降的剂量反应特征似乎有显著差异,可能取决于肺血管和支气管平滑肌对这些激动剂的相对敏感性。非哮喘受试者单次吸入LTC4使PaO2显著下降,肺泡 - 动脉血氧分压差(AaPO2)显著增加,这与FEV1较基线平均(标准误)下降14%(2.5)相关。心输出量平均下降15%(3.4),血压和心率无显著变化。没有心电图证据表明存在心肌缺血。(摘要截短于250字)