Marvin P M, Baker B J, Dutt A K, Murphy M L, Bone R C
Chest. 1983 Dec;84(6):684-9. doi: 10.1378/chest.84.6.684.
At rest and during exercise, noninvasive studies of cardiopulmonary physiology in patients with chronic obstructive pulmonary disease (COPD) were carried out to determine the objective benefits of commonly used oral bronchodilator drugs in 15 stable patients without cardiovascular disease or reversible obstruction of airflow. Theophylline, terbutaline, a combination of theophylline and terbutaline, and placebo were given for ten days each in a randomly sequenced double-blind protocol for outpatients. Spirometric values, the ratio of physiologic dead space to tidal volume (VDp/VT), and the alveolar-arterial oxygen pressure difference (P[A-a]O2) were studied at rest on each regimen. During steady-state exercise the changes in VDp/VT and P(A-a)O2, as well as the ventilatory equivalent for oxygen and oxygen pulse, were measured. When compared with placebo, no significant change was noted in the previously mentioned measurements with any regimen, with the exception of a small improvement in the forced expiratory volume in one second, which was significant for all regimens. These findings suggest that commonly used oral bronchodilator drugs in usual doses may have small effects on airflow even in "irreversible" COPD but that the objective effect of these agents on gas exchange during rest and exercise is not significant.
在静息和运动期间，对15名无心血管疾病或气流可逆性阻塞的稳定期慢性阻塞性肺疾病（COPD）患者进行了心肺生理学的非侵入性研究，以确定常用口服支气管扩张剂的客观益处。门诊患者采用随机序列双盲方案，分别给予茶碱、特布他林、茶碱与特布他林联合用药以及安慰剂，每种药物给药10天。在每种治疗方案下静息时，研究了肺量计值、生理死腔与潮气量之比（VDp/VT）以及肺泡-动脉氧分压差（P[A-a]O2）。在稳态运动期间，测量了VDp/VT和P(A-a)O2的变化，以及氧通气当量和氧脉搏。与安慰剂相比，除一秒用力呼气量有小幅改善（所有治疗方案均显著）外，任何治疗方案的上述测量值均无显著变化。这些发现表明，常用剂量的口服支气管扩张剂即使在“不可逆”的COPD中对气流可能也有微小影响，但这些药物在静息和运动期间对气体交换的客观影响并不显著。
