Chester E H, Schwartz H J, Fleming G M
Chest. 1981 May;79(5):540-4. doi: 10.1378/chest.79.5.540.
Bronchomotor tone is, in part, under beta-adrenergic control, and beta-adrenergic agonists are commonly used in the therapy for chronic obstructive pulmonary disease (COPD). Beta-adrenergic blockade with propranolol is contraindicated in asthmatic patients, yet little is known of its effect in patients with COPD. We studied 13 patients with COPD in a random-entry, double-blind crossover comparison of oral propranolol, 40 mg, and oral placebo on separate day. Pulmonary function worsened after administration of propranolol. Significant differences were present between the drugs' effect on heart rate, airway resistance, specific resistance, and flow rates at one hour, and persisting through four hours (p less than 0.01). Propranolol may have a deleterious effect on pulmonary function in nonasthmatic COPD. We conclude that when propranolol is to be used in patients with COPD, the short- and long-term effects on airway should be measured sequentially.
支气管运动张力部分受β-肾上腺素能控制，β-肾上腺素能激动剂常用于慢性阻塞性肺疾病（COPD）的治疗。哮喘患者禁用普萘洛尔进行β-肾上腺素能阻滞，但对其在COPD患者中的作用了解甚少。我们对13例COPD患者进行了一项随机分组、双盲交叉比较研究，在不同日期分别给予口服40mg普萘洛尔和口服安慰剂。服用普萘洛尔后肺功能恶化。两种药物在1小时时对心率、气道阻力、比气道阻力和流速的影响存在显著差异，并持续至4小时（p<0.01）。普萘洛尔可能对非哮喘性COPD患者的肺功能有有害影响。我们得出结论，当COPD患者使用普萘洛尔时，应依次测量其对气道的短期和长期影响。
