Zainudin B M, Tolfree S E, Short M, Spiro S G
Department of Respiratory Medicine, University College Hospital, London.
Thorax. 1988 Dec;43(12):987-91. doi: 10.1136/thx.43.12.987.
The influence of breathing pattern on lung deposition and bronchodilator response to nebulised salbutamol is uncertain. Three different breathing patterns were assessed in eight patients with chronic stable asthma. Salbutamol solution (2.5 mg in 4 ml) mixed with technetium-99m labelled human serum albumin was nebulised by an Acorn nebuliser at a flow rate of 6 litres a minute. Particles with a mass median aerodynamic diameter of 4.8 microns were produced for inhalation by (a) tidal breathing, (b) six tidal breaths followed by three deep breaths, and (c) six tidal breaths followed by three deep breaths with a five second breath hold after each breath. Each breathing pattern was continued for four minutes. There was no significant difference in the percentage of radioaerosol deposited in the lung or in the distribution of radioaerosol within the lung as assessed by gamma camera imaging. Changes in bronchodilator responses as measured by peak expiratory flow rate (PEF), forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) 30, 45, and 60 minutes after inhalation were similar for the three studies. The mean (SEM) maximum percentage change in FEV1 was 44 (7.1), 47 (9.2), and 51 (8.4) for studies 1, 2, and 3 respectively. The percentage of nebulised solution deposited in the body was also similar for the three breathing patterns--that is, 11-13%, of which 98% entered the lung. This study shows that inhaling a nebulised aerosol by tidal breathing, the simplest method, is as effective as tidal breathing with deep breaths with or without a breath hold.
呼吸模式对肺部沉积以及雾化沙丁胺醇的支气管扩张反应的影响尚不确定。对8例慢性稳定期哮喘患者评估了三种不同的呼吸模式。将沙丁胺醇溶液（4毫升中含2.5毫克）与锝-99m标记的人血清白蛋白混合，用橡果雾化器以每分钟6升的流速进行雾化。产生质量中值空气动力学直径为4.8微米的颗粒以供吸入，吸入方式为：(a) 潮气呼吸；(b) 6次潮气呼吸后接3次深呼吸；(c) 6次潮气呼吸后接3次深呼吸，每次呼吸后屏气5秒。每种呼吸模式持续4分钟。通过γ相机成像评估，肺部放射性气溶胶的沉积百分比或肺部内放射性气溶胶的分布均无显著差异。三项研究中，吸入后30、45和60分钟时，通过呼气峰值流速（PEF）、一秒用力呼气容积（FEV1）和用力肺活量（FVC）测量的支气管扩张反应变化相似。研究1、2和3中，FEV1的平均（SEM）最大百分比变化分别为44（7.1）、47（9.2）和51（8.4）。三种呼吸模式下，雾化溶液在体内的沉积百分比也相似，即11 - 13%，其中98%进入肺部。本研究表明，采用最简单的潮气呼吸方式吸入雾化气溶胶，与伴有或不伴有屏气的深呼吸潮气呼吸方式效果相同。
