Knodel A R, Covelli H D, Beekman J F
West J Med. 1984 May;140(5):741-4.
The indications and usefulness of outpatient serum theophylline determinations were prospectively evaluated by doing 151 of these studies in 137 consecutive cases of chronic obstructive pulmonary disease. We found that evaluations were done for the following three groups of indications: group A, worsening bronchospasm; group B, stable asymptomatic cases, and group C, symptoms suggesting theophylline toxicity. When the three clinical groups were compared for frequency of nontherapeutic values, only an increased frequency of subtherapeutic values in patients with bronchospasm (group A) was significant (P<.01). Increasing the dosage up to 15 mg per kg of body weight a day while theophylline determinations are pending appears to be safe in this group of patients. Toxic symptoms were rarely associated with concentrations greater than 20 mug per ml (3/13) and infrequently occurred in patients with concentrations greater than 20 mug per ml (3/29). Nontherapeutic theophylline values did not always result in an adjustment of theophylline dosage. This was influenced by a correlation of symptoms, timing of the theophylline determination and the use of other bronchodilators.
通过对137例连续的慢性阻塞性肺疾病患者进行151次门诊血清茶碱测定，前瞻性评估了其指征和实用性。我们发现评估针对以下三组指征进行：A组，支气管痉挛加重；B组，稳定无症状病例；C组，提示茶碱中毒的症状。当比较这三个临床组的非治疗性值频率时，仅支气管痉挛患者（A组）的治疗不足值频率增加具有显著性（P<0.01）。在等待茶碱测定期间，将剂量增加至每日每公斤体重15毫克对该组患者似乎是安全的。毒性症状很少与浓度大于20微克/毫升相关（3/13），且在浓度大于20微克/毫升的患者中很少发生（3/29）。非治疗性茶碱值并不总是导致茶碱剂量调整。这受到症状相关性、茶碱测定时间以及其他支气管扩张剂使用的影响。
