Chen W Y, Brenner A M, Weiser P C, Chai H
Chest. 1981 Jun;79(6):651-6. doi: 10.1378/chest.79.6.651.
Six asthmatic children were studied to determine whether supplemental, parenteral atropine would increase the effects of bronchodilation and protection against exercise-induced bronchoconstriction after maximal effects had been achieved by inhalation. First, we determined the amount of inhaled atropine sulfate that would give maximal bronchodilation for each patient at rest. This quantity of atropine was designated as "A." Then all subjects exercised for five sessions with the following pre-exercise treatments in a random order: (a) inhaled distilled water plus intramuscular (IM) saline solution; (b) inhaled A dose of atropine plus IM saline solution; (c) inhaled distilled water plus 0.35 mg IM atropine; (d) inhaled A dose of atropine plus 0.35 mg IM atropine; and (e) inhaled double the A dose plus IM saline solution. The results showed that the combination of inhaled and IM atropine had the greatest bronchodilation effect and the greatest protection against exercise-induced bronchoconstriction. Atropine inhalation alone (A dose) or IM injection (0.35 mg) was not as effective in bronchodilation or in alleviation of exercise-induced bronchoconstriction. Doubling the dose of inhalation (2A) did not increase the effects of the A dose. These results support the hypothesis that inhaled atropine does not reach all the airways where cholinergic receptors are present.
对六名哮喘儿童进行了研究，以确定在通过吸入达到最大效果后，补充注射用阿托品是否会增强支气管扩张作用以及预防运动诱发的支气管收缩。首先，我们确定了使每位患者在静息时达到最大支气管扩张的硫酸阿托品吸入量。该阿托品量被指定为“A”。然后，所有受试者按随机顺序接受以下运动前治疗进行五次运动：(a) 吸入蒸馏水加肌肉注射 (IM) 生理盐水；(b) 吸入 A 剂量阿托品加 IM 生理盐水；(c) 吸入蒸馏水加 0.35 mg IM 阿托品；(d) 吸入 A 剂量阿托品加 0.35 mg IM 阿托品；以及 (e) 吸入两倍 A 剂量加 IM 生理盐水。结果表明，吸入和 IM 阿托品联合使用具有最大的支气管扩张作用以及对运动诱发的支气管收缩的最大保护作用。单独吸入阿托品（A 剂量）或 IM 注射（0.35 mg）在支气管扩张或缓解运动诱发的支气管收缩方面效果不佳。将吸入剂量加倍（2A）并未增加 A 剂量的效果。这些结果支持了以下假设：吸入的阿托品并未到达所有存在胆碱能受体的气道。
