Lötvall J, Svedmyr N
Department of Clinical Pharmacology, Shalgrenska University Hospital, Göteborg, Sweden.
Lung. 1993;171(5):249-64. doi: 10.1007/BF03215869.
Salmeterol (Serevent) is an inhaled beta 2-receptor agonist with more than twelve hours' effect duration compared with 4-6 hours for the more short-acting substances bitolterol, fenoterol, salbutamol, and terbutaline. Salmeterol has been studied in several large-scale double-blind multicenter studies with up to one year's duration. More than 6,000 asthmatics have been treated with salmeterol during these controlled studies. All studies show salmeterol to have a significantly better and well-maintained bronchodilating effect with better asthma control, fewer asthma exacerbations, and a decreased need for rescue albuterol inhalations used on demand compared to the treatments in the control groups (200-400 micrograms albuterol q.i.d., inhaled albuterol given only p.r.n., terbutaline given regularly, or individually titrated slow-release theophylline). Salmeterol should be given b.i.d. and in combination with inhaled corticosteroids. Salmeterol seems especially effective in patients with nocturnal symptoms, exercise induced asthma, and in patients sensitive to inhaled irritants such as cold air. The patients should always have short-acting inhaled beta 2-agonists available for break-through attacks. Inhaled salmeterol in combination with inhaled steroids seems to give the best maintenance asthma control available by inhalation today.
沙美特罗（施立稳）是一种吸入性β2受体激动剂，其作用持续时间超过12小时，相比之下，作用更短效的药物如双甲苯喘定、非诺特罗、沙丁胺醇和特布他林的作用持续时间为4 - 6小时。沙美特罗已在多项长达一年的大规模双盲多中心研究中进行了研究。在这些对照研究中，超过6000名哮喘患者接受了沙美特罗治疗。所有研究均表明，与对照组的治疗方法（200 - 400微克沙丁胺醇每日4次、仅在需要时吸入沙丁胺醇、定期给予特布他林或个体化滴定缓释茶碱）相比，沙美特罗具有显著更好且维持良好的支气管扩张作用，能更好地控制哮喘，减少哮喘发作次数，减少按需使用急救沙丁胺醇吸入剂的需求。沙美特罗应每日两次给药，并与吸入性糖皮质激素联合使用。沙美特罗在有夜间症状、运动诱发性哮喘以及对吸入性刺激物（如冷空气）敏感的患者中似乎特别有效。患者应始终备有短效吸入性β2激动剂以应对突发发作。吸入性沙美特罗与吸入性类固醇联合使用似乎能提供目前通过吸入实现的最佳哮喘维持控制效果。
