Papiris S, Galavotti V, Sturani C
Respiration. 1986;49(2):101-8. doi: 10.1159/000194866.
In a single-blind placebo-controlled trial in 12 patients with advanced chronic obstructive pulmonary disease (COPD) we compared the effects of nebulized salbutamol (1 mg), clenbuterol (30 micrograms) and placebo (4 ml of normal saline) on spirometric indices (FVC, FEV1), maximal expiratory flows (Vmax50 and Vmax25), the distance walked in 6 min (6MD), assessment of breathlessness by visual analogue scale (VAS), and estimates by the patients of perceived exertion (RPE). Both clenbuterol and salbutamol produced significant increases in FEV1, FVC, Vmax50 and Vmax25. With both drugs, 6MD increased significantly (p less than 0.01) and breathlessness decreased significantly without an appreciable increase in RPE after exercise despite the extra distance covered. The absolute improvements in FEV1 and 6MD after clenbuterol were correlated (r = 0.763, p less than 0.01), but these indices were not correlated after salbutamol (r = 0.121, p greater than 0.1). The lack of correlation between the changes in 6MD and FEV1 after salbutamol might indicate that relief of airways obstruction is not the only explanation for the effects on distance walked, at least with salbutamol.
在一项针对12例晚期慢性阻塞性肺疾病（COPD）患者的单盲安慰剂对照试验中，我们比较了雾化吸入沙丁胺醇（1毫克）、克伦特罗（30微克）和安慰剂（4毫升生理盐水）对肺量计指标（用力肺活量[FVC]、第一秒用力呼气容积[FEV1]）、最大呼气流量（Vmax50和Vmax25）、6分钟步行距离（6MD）、通过视觉模拟评分法（VAS）评估的呼吸困难程度以及患者自我感觉的运动强度（RPE）的影响。克伦特罗和沙丁胺醇均使FEV1、FVC、Vmax50和Vmax25显著增加。使用这两种药物后，6MD均显著增加（p<0.01），呼吸困难程度显著降低，尽管运动后行走距离增加，但RPE没有明显升高。使用克伦特罗后，FEV1和6MD的绝对改善具有相关性（r = 0.763，p<0.01），但使用沙丁胺醇后这些指标无相关性（r = 0.121，p>0.1）。使用沙丁胺醇后6MD和FEV1变化之间缺乏相关性可能表明，至少对于沙丁胺醇来说，气道阻塞的缓解并非对步行距离产生影响的唯一解释。
