Filuk R B, Easton P A, Anthonisen N R
Am Rev Respir Dis. 1985 Oct;132(4):871-4. doi: 10.1164/arrd.1985.132.4.871.
To assess additive effects of therapy with salbutamol and theophylline, we examined 16 patients (5 women, 11 men) with a mean age of 67.6 +/- 6.9 (SE) yr, long-standing chronic obstructive pulmonary disease, an FEV1 of 0.73 +/- 0.05 (SE) L, and a smoking history of 38.4 +/- 4.1 (SE) pack-years. On 2 consecutive days they were given large doses of either salbutamol followed by theophylline or vice versa. In the group as a whole, responses to salbutamol alone averaged 24% of the baseline FEV1 and responses to theophylline alone were 17% of baseline. Similar increases were observed when either drug was given after the other; responses to the 2 agents were additive. Responses to salbutamol were larger (p less than 0.05) than those to theophylline. Responses to salbutamol and theophylline were correlated. In 8 patients whose FEV1 increased after salbutamol by more than both 20% and 0.2 L, adding theophylline produced responses that were also large (32% baseline and 0.22 L). In the remaining 8 nonresponsive patients, salbutamol and theophylline were also additive, but the small (mean 10% or 0.06 L) increases in FEV1 with theophylline raised the question of the risk benefit ratio of high-dose theophylline therapy in such patients.
为评估沙丁胺醇与茶碱联合治疗的附加效应，我们对16例患者（5例女性，11例男性）进行了研究，这些患者的平均年龄为67.6±6.9（标准误）岁，患有长期慢性阻塞性肺疾病，第一秒用力呼气容积（FEV1）为0.73±0.05（标准误）L，吸烟史为38.4±4.1（标准误）包年。在连续2天里，他们被给予大剂量的沙丁胺醇后再给予茶碱，或者反之。在整个组中，单独使用沙丁胺醇时的反应平均为基线FEV1的24%，单独使用茶碱时的反应为基线的17%。当两种药物先后给予时观察到类似的增加；对两种药物的反应是相加的。对沙丁胺醇的反应大于对茶碱的反应（P<0.05）。对沙丁胺醇和茶碱的反应具有相关性。在8例使用沙丁胺醇后FEV1增加超过20%且增加量超过0.2 L的患者中，加用茶碱后的反应也很大（为基线的32%和增加0.22 L）。在其余8例无反应的患者中，沙丁胺醇和茶碱的作用也是相加的，但茶碱使FEV1出现的较小增加（平均10%或0.06 L）引发了对于此类患者高剂量茶碱治疗风险效益比的疑问。
