Subudhi Andrew W, Evero Oghenero, Reitinger Jeremy, Davis Christopher, Gronewold Jeffrey, Nichols Andrew J, Van-Houten Sonja Jameson, Roach Robert C
Altitude Research Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Human Physiology and Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO, USA.
Exp Physiol. 2021 Jan;106(1):117-125. doi: 10.1113/EP088461. Epub 2020 May 26.
What is the central question of this study? Does the combination of methazolamide and theophylline reduce symptoms of acute mountain sickness (AMS) and improve aerobic performance in acute hypobaric hypoxia? What is the main finding and its importance? The oral combination of methazolamide (100 BID) and theophylline (300 BID) improved arterial oxygen saturation but did not reduce symptoms of AMS and impaired aerobic performance. We do not recommend this combination of drugs for prophylaxis against the acute negative effects of hypobaric hypoxia.
A limited number of small studies have suggested that methazolamide and theophylline can independently reduce symptoms of acute mountain sickness (AMS) and, if taken together, can improve aerobic exercise performance in normobaric hypoxia. We performed a randomized, double-blind, placebo-controlled, cross-over study to determine if the combination of oral methazolamide and theophylline could provide prophylaxis against AMS and improve aerobic performance in hypobaric hypoxia (∼4875 m). Volunteers with histories of AMS were screened at low altitude (1650 m) and started combined methazolamide (100 mg BID) and theophylline (300 mg BID) treatment, or placebo, 72 h prior to decompression. Baseline AMS (Lake Louise Questionnaire), blood (haemoglobin, haematocrit), cognitive function, ventilatory and pulse oximetry ( ) measures were assessed at low altitude and repeated between 4 and 10 h of exposure to hypobaric hypoxia (P = 425 mmHg). Aerobic exercise performance was assessed during a 12.5 km cycling time trial (TT) after 4 h of hypobaric hypoxia. Subjects repeated all experimental procedures after a 3-week washout period. Differences between drug and placebo trials were evaluated using repeated measures ANOVA (α = 0.05). The drugs improved resting by ∼4% (P < 0.01), but did not affect the incidence or severity of AMS or cognitive function scores relative to placebo. Subjects' performance on the 12.5 km TT was ∼3% worse when taking the drugs (P < 0.01). The combination of methazolamide and theophylline in the prescribed dosages is not recommended for use at high altitude as it appears to have no measurable effect on AMS and can impair aerobic performance.
本研究的核心问题是什么？醋甲唑胺和茶碱联合使用能否减轻急性高原病（AMS）症状并改善急性低压缺氧时的有氧运动能力？主要发现及其重要性是什么？口服醋甲唑胺（100毫克，每日两次）和茶碱（300毫克，每日两次）可提高动脉血氧饱和度，但不能减轻AMS症状，且会损害有氧运动能力。我们不推荐使用这种药物组合来预防低压缺氧的急性负面影响。
少数小型研究表明，醋甲唑胺和茶碱可分别减轻急性高原病（AMS）症状，若联合使用，可改善常压缺氧时的有氧运动能力。我们进行了一项随机、双盲、安慰剂对照、交叉研究，以确定口服醋甲唑胺和茶碱联合使用是否能预防AMS并改善低压缺氧（约4875米）时的有氧运动能力。有AMS病史的志愿者在低海拔（1650米）进行筛查，并在减压前72小时开始服用醋甲唑胺（100毫克，每日两次）和茶碱（300毫克，每日两次）联合治疗或安慰剂。在低海拔评估基线AMS（路易斯湖问卷）、血液（血红蛋白、血细胞比容）、认知功能、通气和脉搏血氧饱和度（ ）指标，并在暴露于低压缺氧（P = 425毫米汞柱）4至10小时期间重复评估。在低压缺氧4小时后，通过12.5公里自行车计时赛（TT）评估有氧运动能力。受试者在3周洗脱期后重复所有实验程序。使用重复测量方差分析（α = 0.05）评估药物试验和安慰剂试验之间的差异。药物使静息 提高约4%（P < 0.01），但与安慰剂相比，对AMS的发生率或严重程度或认知功能评分无影响。服用药物时，受试者在12.5公里TT上的表现比服用安慰剂时差约3%（P < 0.01）。不推荐按规定剂量联合使用醋甲唑胺和茶碱，因为它似乎对AMS没有可测量的影响，且会损害有氧运动能力。
