Benedetti M, Spezia E, Comis A, Marcer G, Boner A L
Department of Pediatrics, University of Verona, Italy.
Respiration. 1993;60(6):319-24. doi: 10.1159/000196229.
Increased bronchial hyperresponsiveness (BHR) has been reported in adult asthmatic patients after regular treatment with beta 2-agonists. In this study we evaluated the effect of a 4-weeks treatment period with broxaterol, a new beta 2-agonist, on BHR in asthmatic children living in two different environmental conditions. Two groups of patients, 24 domiciled at sea level, allergen exposed (group 1), and 24 resident at high altitude (Misurina, 1,756 m) in an allergen-free environment (group 2), have been tested. Children were randomly treated with broxaterol 400 micrograms q.i.d. or sodium chromoglycate 10 mg q.i.d. (as control treatment) by the metered dose inhaler for 4 weeks. Pulmonary function tests and methacholine challenge were performed at the beginning and at the end of the study. Throughout the study period a diary card was completed and peak expiratory flow rate (PEFR) was measured three times daily. Forty-two of the patients admitted concluded the study. No significant change was observed in the methacholine PC20 throughout the study period regardless of the type of treatment and/or environment. The amplitude percentage mean of diurnal changes in PEFR during the study period showed no statistically significant differences between treatments or centres, or in the interaction of treatment with centre, time with treatment, time with centre, time with centre and treatment (p > 0.05). Therefore in this pilot study regular treatment with broxaterol for 4 weeks did not cause an increase in BHR in asthmatic children both in conditions of allergen exposure and in an environment free of offending allergens.
据报道,成年哮喘患者在接受β2激动剂常规治疗后支气管高反应性(BHR)增加。在本研究中,我们评估了新型β2激动剂布地那罗4周治疗期对生活在两种不同环境条件下的哮喘儿童BHR的影响。测试了两组患者,一组24名居住在海平面、暴露于过敏原环境中(第1组),另一组24名居住在高海拔地区(米苏里纳,海拔1756米)、处于无过敏原环境中(第2组)。通过定量吸入器,儿童被随机给予布地那罗400微克每日4次或色甘酸钠10毫克每日4次(作为对照治疗),为期4周。在研究开始和结束时进行肺功能测试和乙酰甲胆碱激发试验。在整个研究期间,完成一份日记卡,并每天测量3次呼气峰值流速(PEFR)。42名入组患者完成了研究。无论治疗类型和/或环境如何,在整个研究期间乙酰甲胆碱PC20均未观察到显著变化。研究期间PEFR昼夜变化的平均幅度百分比在治疗组或研究中心之间、治疗与中心的交互作用、时间与治疗的交互作用、时间与中心的交互作用以及时间与中心和治疗的交互作用方面均无统计学显著差异(p>0.05)。因此,在这项初步研究中,无论是在过敏原暴露条件下还是在无有害过敏原的环境中,布地那罗4周的常规治疗均未导致哮喘儿童BHR增加。