Haber P, Harmuth P, Wolf C, Mayr N, Zeithofer J
II. Medizinische Universitäts-Klinik, Wien, Osterreich.
Respiration. 1987;52(1):59-68. doi: 10.1159/000195305.
The acute effects of a single intravenous Prostigmin injection (0.5 mg) on lung function and gas exchange during rest and bicycle ergometry were measured in 26 patients with myasthenia gravis. The mean age of the patients was 44.6 +/- 17.6 years and the mean duration of myasthenia gravis 5.4 +/- 6.3 years. Lung function parameters obtained from 15 patients showed a normal total lung capacity with an increase in functional residual capacity and residual volume, while vital capacity was diminished. While the application of Prostigmin showed no acute effects on these lung volumes, there was a significant increase in airway resistance, even into the pathologic range. Data obtained during spiro-ergometry concerning gas exchange, circulation and muscle metabolism correspond to those expected from healthy individuals; application of Prostigmin did only influence the heart rate, which can be explained by parasympathomimetic activity. We conclude that dyspnoea in patients with myasthenia gravis need not necessarily be a symptom of the illness itself but can also be caused by therapy; in the latter case bronchodilatators are required.
对26例重症肌无力患者静脉注射一次新斯的明（0.5毫克）后，测量其静息和自行车测力计运动期间的肺功能及气体交换的急性效应。患者的平均年龄为44.6±17.6岁，重症肌无力的平均病程为5.4±6.3年。15例患者的肺功能参数显示，总肺容量正常，功能残气量和残气量增加，而肺活量减少。虽然新斯的明的应用对这些肺容量没有急性影响，但气道阻力显著增加，甚至达到病理范围。在运动肺量计测量期间获得的有关气体交换、循环和肌肉代谢的数据与健康个体预期的数据一致；新斯的明的应用仅影响心率，这可以用拟副交感神经活性来解释。我们得出结论，重症肌无力患者的呼吸困难不一定是疾病本身的症状，也可能由治疗引起；在后一种情况下，需要使用支气管扩张剂。
