Eaton M L, MacDonald F M, Church T R, Niewoehner D E
Chest. 1982 Nov;82(5):538-42. doi: 10.1378/chest.82.5.538.
Theophylline is commonly prescribed for patients with nonasthmatic chronic airflow obstruction (CAO) even though clinical efficacy is not well established. We studied objective and subjective responses to theophylline in 14 men with CAO. Subjects randomly received week-long treatments of placebo or theophylline at two dosages: one that produced low (8.7-13.0 micrograms/ml) and the other high (16.0-23.6 micrograms/ml plasma concentrations. During the final three days of each treatment, we measured spirometric and hemodynamic function. Exercise tolerance was assessed with the 12 minute walk and progressive cycle ergometry. The patients' perception of breathlessness during the usual activities of daily living was evaluated with the oxygen cost diagram and the breathlessness rating. For low and high dose theophylline there were significant (p less than .05) increases in forced vital capacity (7.1 +/- 2.1 percent; 12.0 +/- 1.7 percent), forced expiratory volume at one second (14.6 +/- 4.9 percent; 12.1 +/- 3.3 percent) and in pulse rate (8.3 +/- 1.2 percent; 19.1 +/- 3.1 percent), but no changes in blood pressure. There were also no significant differences among the three treatments for any of the tests which assessed exercise tolerance or breathlessness. These results suggest that most patients with CAO experience little symptomatic benefit from taking theophylline.
尽管茶碱对非哮喘性慢性气流阻塞（CAO）患者的临床疗效尚未完全明确，但它仍是常用的处方药。我们研究了14名CAO男性患者对茶碱的客观和主观反应。受试者随机接受为期一周的安慰剂或两种剂量茶碱的治疗：一种剂量产生低血浆浓度（8.7 - 13.0微克/毫升），另一种产生高血浆浓度（16.0 - 23.6微克/毫升）。在每种治疗的最后三天，我们测量了肺功能和血流动力学功能。通过12分钟步行和递增式自行车测力计评估运动耐力。使用氧耗图和呼吸困难评分评估患者在日常生活活动中的呼吸困难感受。对于低剂量和高剂量茶碱，用力肺活量（分别增加7.1±2.1%；12.0±1.7%）、一秒用力呼气量（分别增加14.6±4.9%；12.1±3.3%）和脉搏率（分别增加8.3±1.2%；19.1±3.1%）均有显著增加（p<0.05），但血压无变化。在评估运动耐力或呼吸困难的任何测试中，三种治疗之间也没有显著差异。这些结果表明，大多数CAO患者服用茶碱后症状改善不明显。
