Brown S E, Prager R S, Shinto R A, Fischer C E, Stansbury D W, Light R W
Chest. 1986 Jan;89(1):7-11. doi: 10.1378/chest.89.1.7.
The purpose of this study was to evaluate the effects of inhaled atropine sulfate on the exercise capacity and cardiopulmonary responses to exercise in patients with chronic airflow obstruction (CAO). Eighteen patients underwent duplicate incremental (15 watts/min) maximal cycle ergometer exercise tests 60 minutes after either inhaled atropine (0.075 mg/kg) or placebo, in double blind randomized fashion on consecutive days. Bronchodilator medications were withheld before each study. Spirograms were obtained before and 60 minutes after each aerosol treatment. Atropine increased the FEV1 by 25 percent, from 1.37 +/- 0.49 to 1.71 +/- 0.52 L (p less than 0.001), as compared to placebo. Although the ventilation at exhaustion (VEmax) increased significantly (from 52.3 +/- 11.5 to 55.9 +/- 10.0 L/min, P less than 0.05) after atropine, the increase in the mean maximum work load (95 +/- 28 vs 101 +/- 19 watts) did not achieve significance. The drug resulted in a significant decrease in oxygen consumption at all equivalent workloads greater than "0" watts (unloaded cycling), presumably because the improvement in airway mechanics decreased the oxygen cost of ventilation. Atropine-induced increases in FEV1 did not result in a significant group mean increase in maximum exercise capacity, but the drug did result in a lower oxygen cost of performing work in patients with CAO.
本研究的目的是评估吸入硫酸阿托品对慢性气流阻塞（CAO）患者运动能力及运动时心肺反应的影响。18例患者连续两天以双盲随机方式，在吸入阿托品（0.075mg/kg）或安慰剂60分钟后，进行两次递增（15瓦/分钟）的最大蹬车运动试验。每次研究前停用支气管扩张剂药物。在每次气雾剂治疗前及治疗后60分钟进行肺量计测定。与安慰剂相比，阿托品使第一秒用力呼气量（FEV1）增加了25%，从1.37±0.49升增至1.71±0.52升（p＜0.001）。虽然吸入阿托品后力竭时通气量（VEmax）显著增加（从52.3±11.5升至55.9±10.0升/分钟，P＜0.05），但平均最大工作负荷的增加（95±28瓦对101±19瓦）未达显著水平。该药物使所有大于“0”瓦（无负荷蹬车）的等效工作负荷下的耗氧量显著降低，推测是因为气道力学的改善降低了通气的氧耗。阿托品引起的FEV1增加并未使最大运动能力的组均值显著增加，但该药物确实降低了CAO患者运动时的氧耗。
