Georgopoulos D, Wong D, Anthonisen N R
Department of Medicine, University of Manitoba, Winnipeg, Canada.
Am Rev Respir Dis. 1988 Dec;138(6):1499-503. doi: 10.1164/ajrccm/138.6.1499.
It has been previously shown that inhaled salbutamol (S) and intravenous aminophylline (A) have an additive effect as bronchodilators in patients with chronic obstructive pulmonary disease (COPD). This additive effect could be due to different modes of action or different distributions of drug. In order to investigate the additive effect of S and A when administered by the same route, we studied eight patients 63.4 +/- 1.84 yr of age (mean +/- SEM), with long-standing COPD (FEV1, 0.96 +/- 0.12 L) by giving them intravenous A and S. A double-blind, cross-over study was performed on two separate days by administering either A followed by S or vice versa. Each drug when given alone increased the FEV1 significantly (p less than 0.01). The mean increase was 0.17 +/- 0.06 L (18% of baseline) for S and 0.15 +/- 0.05 L (17% of baseline) for A. The FEV1 increased 0.07 +/- 0.02 L when S was added to A (95% confidence interval, 0.02 to 0.12, 7% of baseline), and when A was added to S 0.05 +/- 0.03 L (95% confidence interval, -0.02 to 0.12, 6% of baseline). Neither change was significant. Heart rate (HR) was increased significantly (p less than 0.01) by S (22 +/- 3.4%), but not by A when it was given first. However, addition of the second drug increased HR significantly (p less than 0.01) from HR with one drug alone; the mean increase was 31 +/- 8.5% of baseline with the addition of S, and 19 +/- 4.06% of baseline with the addition of A.(ABSTRACT TRUNCATED AT 250 WORDS)
先前的研究表明，吸入沙丁胺醇（S）和静脉注射氨茶碱（A）对慢性阻塞性肺疾病（COPD）患者具有相加的支气管扩张作用。这种相加作用可能是由于不同的作用方式或药物的不同分布。为了研究S和A经相同途径给药时的相加作用，我们对8名年龄为63.4±1.84岁（均值±标准误）、患有长期COPD（第1秒用力呼气容积[FEV1]为0.96±0.12L）的患者给予静脉注射A和S进行了研究。在两个不同的日子进行了一项双盲、交叉研究，给药顺序为A后接S或反之。每种药物单独给药时均显著增加FEV1（p<0.01）。S的平均增加量为0.17±0.06L（占基线的18%），A为0.15±0.05L（占基线的17%）。当S加到A中时，FEV1增加0.07±0.02L（95%置信区间为0.02至0.12，占基线的7%），当A加到S中时增加0.05±0.03L（95%置信区间为-0.02至0.12，占基线的6%）。两种变化均无显著性。S使心率（HR）显著增加（p<0.01）（增加22±3.4%），但先给予A时未使其增加。然而，添加第二种药物使HR较单独使用一种药物时显著增加（p<0.01）；添加S时平均增加量为基线的31±8.5%，添加A时为基线的19±4.06%。（摘要截短于250词）
