Liggett S B, Daughaday C C, Senior R M
Respiratory Division Jewish Hospital, Washington University Medical Center, St. Louis.
Chest. 1988 Jul;94(1):210-2. doi: 10.1378/chest.94.1.210.
Three patients with chronic obstructive lung disease (COPD) and myasthenia gravis whose pulmonary symptoms were worsened by therapy with cholinesterase inhibitors were improved by inhaled ipratropium bromide. Two had increases in FEV1 (19 percent, 35 percent) and specific conductance (106 percent, 81 percent) and reductions in dyspnea. The third had no change in airflow with ipratropium, but improved due to decreased bronchial secretions which had limited the use of cholinesterase inhibitors. In contrast, beta agonist bronchodilators had no effect in any of these patients. This experience suggests that ipratropium may be the bronchodilator drug of choice in patients with obstructive lung disease aggravated by cholinesterase inhibitors.
三名患有慢性阻塞性肺疾病（COPD）并伴有重症肌无力的患者，其肺部症状因胆碱酯酶抑制剂治疗而加重，吸入异丙托溴铵后症状得到改善。其中两名患者的第一秒用力呼气容积（FEV1）增加（分别为19%、35%），比气道传导率增加（分别为106%、81%），呼吸困难减轻。第三名患者使用异丙托溴铵后气流无变化，但因支气管分泌物减少而病情改善，此前支气管分泌物限制了胆碱酯酶抑制剂的使用。相比之下，β受体激动剂支气管扩张剂对这些患者均无效果。这一经验表明，对于因胆碱酯酶抑制剂加重的阻塞性肺疾病患者，异丙托溴铵可能是首选的支气管扩张剂。
