Brown I G, Chan C S, Kelly C A, Dent A G, Zimmerman P V
Thorax. 1984 Apr;39(4):272-6. doi: 10.1136/thx.39.4.272.
The effect of adding nebulised ipratropium bromide to bronchodilator treatment was studied in 20 patients with severe chronic airflow limitation. Maintenance theophylline with or without a steroid preparation was continued and comparison made between placebo, nebulised salbutamol, and a combination of nebulised salbutamol and ipratropium. Although the mean FEV1 values showed the combination to produce a small but significant increase in peak bronchodilatation over the effect of salbutamol alone, there were eight patients in whom no clinically useful improvement occurred. The remaining 12 patients did obtain clinically useful improvement in the magnitude or the duration of bronchodilatation (or both) as a result of the added ipratropium. The conclusion is that individual patients with chronic airflow limitation responded to the addition of nebulised ipratropium bromide in a variable way. Patients who could obtain additional benefit from ipratropium need to be identified by an appropriate reversibility study before its inclusion in their bronchodilator treatment.
在20例严重慢性气流受限患者中，研究了在支气管扩张剂治疗中添加雾化异丙托溴铵的效果。持续使用维持剂量的茶碱，无论是否联合使用类固醇制剂，并对安慰剂、雾化沙丁胺醇以及雾化沙丁胺醇与异丙托溴铵的联合用药进行比较。尽管平均第一秒用力呼气容积（FEV1）值显示联合用药较单独使用沙丁胺醇在最大支气管扩张效果上有小幅但显著的增加，但仍有8例患者未出现临床上有效的改善。其余12例患者因添加异丙托溴铵，在支气管扩张的程度或持续时间（或两者）上确实获得了临床上有效的改善。结论是，慢性气流受限的个体患者对添加雾化异丙托溴铵的反应各不相同。在将异丙托溴铵纳入支气管扩张剂治疗之前，需要通过适当的可逆性研究来确定哪些患者能从异丙托溴铵中获得额外益处。
