McSharry R J, Kirsch C M, Jensen W A, Kagawa F T
Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, California.
Am J Med Sci. 1993 Jul;306(1):20-2. doi: 10.1097/00000441-199307000-00006.
The frequent occurrence of bronchospasm due to aerosolized pentamidine (AP) may reduce delivery of drugs to distal airways and produce symptoms that limit therapy. This study performed spirometric measurements before and after AP treatment in 30 human immunodeficiency virus seropositive patients over 18 months. Patients reporting symptoms of bronchospasm were treated with prophylactic beta-agonist aerosol before subsequent AP treatment. Forty percent of patients reported symptoms. This group had significant declines in forced expiratory volume in 1 second associated with AP, whereas the asymptomatic group had no decline in forced expiratory volume in 1 second. Bronchodilator prophylaxis eliminated AP-induced symptoms and spirometric changes. Baseline spirometry did not change after five monthly treatments. The close relationship between symptoms and acute spirometric changes, the lack of progressive airway obstruction due to AP, and the reliable response to beta-agonist therapy make a symptom-based approach to treatment possible.
雾化喷他脒（AP）导致的支气管痉挛频繁发生，可能会减少药物向远端气道的输送，并产生限制治疗的症状。本研究在18个月内对30例18岁以上的人类免疫缺陷病毒血清阳性患者在接受AP治疗前后进行了肺量测定。报告有支气管痉挛症状的患者在随后的AP治疗前接受预防性β-激动剂气雾剂治疗。40%的患者报告有症状。该组患者1秒用力呼气量与AP相关显著下降，而无症状组1秒用力呼气量无下降。支气管扩张剂预防消除了AP诱导的症状和肺量测定变化。每月进行五次治疗后，基线肺量测定未发生变化。症状与急性肺量测定变化之间的密切关系、AP未导致进行性气道阻塞以及对β-激动剂治疗的可靠反应使得基于症状的治疗方法成为可能。
