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[茶碱对慢性阻塞性肺疾病患者通气调节的影响]

[Effects of theophylline on ventilatory regulation in patients with chronic obstructive pulmonary disease].

作者信息

Ikeda A, Senju S, Toyoshima H, Miyahara S, Aritomi T, Watanabe K, Ishibashi M, Yoshida M

机构信息

Second Department of Internal Medicine, School of Medicine, Fukuoka University, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Nov;31(11):1441-8.

PMID:8277616
Abstract

The effects and the mechanism of single and long-term administration of theophylline on ventilatory regulation were investigated in patients with chronic obstructive pulmonary disease (COPD). The ventilatory and mouth occlusion pressure (P0.1) responses during CO2 rebreathing were measured before and 4 hours after oral, single administration of theophylline in 15 patients with pulmonary emphysema, 15 patients with asthma and 10 healthy subjects. Ventilatory response to CO2 (VE/PCO2) was increased in patients with asthma and P0.1 response to CO2 (P0.1/PaCO2) was increased in patients with pulmonary emphysema after single theophylline administration. In patients with pulmonary emphysema, the increase in P0.1 was more marked than that in maximum inspiratory pressure static (MIPS). The effect of long-term administration of theophylline was studied in 8 patients with COPD and 8 patients with restrictive lung disease. In patients with COPD, P0.1/PaCO2 was significantly increased and the increase was maintained until three months later. These findings suggest that theophylline is effective in improving ventilatory and occlusion pressure responses to CO2 in patients with asthma probably by its bronchodilating effect, and in patients with pulmonary emphysema by its direct effect on the ventilatory control system.

摘要

在慢性阻塞性肺疾病(COPD)患者中研究了单次及长期给予茶碱对通气调节的影响及机制。在15例肺气肿患者、15例哮喘患者和10名健康受试者中,测量了口服单次给予茶碱前及给药后4小时二氧化碳再吸入期间的通气和口腔阻断压(P0.1)反应。单次给予茶碱后,哮喘患者的二氧化碳通气反应(VE/PCO2)增加,肺气肿患者的二氧化碳P0.1反应(P0.1/PaCO2)增加。在肺气肿患者中,P0.1的增加比静态最大吸气压力(MIPS)的增加更明显。在8例COPD患者和8例限制性肺病患者中研究了长期给予茶碱的效果。在COPD患者中,P0.1/PaCO2显著增加,且这种增加持续到三个月后。这些发现表明,茶碱可能通过其支气管扩张作用有效改善哮喘患者对二氧化碳的通气和阻断压反应,而对肺气肿患者则通过其对通气控制系统的直接作用发挥效果。

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