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健康受试者和哮喘患者气道中的β-肾上腺素能功能

Beta-adrenergic function in airways of healthy and asthmatic subjects.

作者信息

Gayrard P, Orehek J, Grimaud C, Charpin J

出版信息

Thorax. 1975 Dec;30(6):657-62. doi: 10.1136/thx.30.6.657.

Abstract

We measured the short-term effects of beta-adrenergic blockade with propranolol (0.2 mg/kg iv), followed by stimulation with salbutamol (200 mug inhaled), on specific airway conductance (SGaw) heart rate, and systemic blood pressure (BP) in 11 healthy subjects, and 11 symptom-free asthmatics with normal lung function values. Propranolol induced a significant bronchoconstrictor effect in both groups, stronger in asthmatics than in normals: mean SGaw decreased 34.6 +/- 25% against 9.4 +/- 9% (p less than 0.01). Six of the 11 asthmatics exhibited a more pronounced bronchoconstriction than the most responsive healthy subject. Large individual variations were seen in both groups although they were greater in the asthmatics. A similar rise in SGaw was produced by salbutamol in both groups. The decrease of heart rate provoked by propranolol was similar in the two groups, averaging 18.6%, with no further change after salbutamol. The blood pressure was slightly decreased by propranolol in both groups. The results indicate that normal subjects have a weak and variable bronchodilator beta-adrenergic activity. In most asthmatics beta-adrenergic tone appeared more pronounced. The individual differences in response to propranolol observed in both groups suggest that asthmatic patients differ quantitatively rather than qualitatively from healthy subjects with respect to beta-adrenergic receptor function. There was no association between clinical findings and the degree of bronchomotor effect of propranolol in the patients with asthma. This study does not support the view that airways of asthmatic patients have a decreased beta-adrengeric receptor function.

摘要

我们测定了普萘洛尔(0.2毫克/千克静脉注射)进行β-肾上腺素能阻滞,随后吸入沙丁胺醇(200微克)对11名健康受试者以及11名肺功能值正常且无症状的哮喘患者的比气道传导率(SGaw)、心率和体循环血压(BP)的短期影响。普萘洛尔在两组中均引起显著的支气管收缩效应,哮喘患者中的效应比正常人更强:平均SGaw下降34.6±25%,而正常人为9.4±9%(p<0.01)。11名哮喘患者中有6名表现出比反应最强烈的健康受试者更明显的支气管收缩。两组中均观察到较大的个体差异,不过哮喘患者中的差异更大。两组中沙丁胺醇均使SGaw产生类似的升高。普萘洛尔引起的心率下降在两组中相似,平均为18.6%,吸入沙丁胺醇后无进一步变化。两组中普萘洛尔均使血压略有下降。结果表明,正常受试者具有微弱且可变的支气管扩张β-肾上腺素能活性。在大多数哮喘患者中,β-肾上腺素能张力似乎更明显。两组中观察到的对普萘洛尔反应的个体差异表明,哮喘患者在β-肾上腺素能受体功能方面与健康受试者的差异在于数量而非质量。哮喘患者的临床发现与普萘洛尔的支气管运动效应程度之间无关联。本研究不支持哮喘患者气道β-肾上腺素能受体功能降低的观点。

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