Mannino F, Anticoli S, De Luca A, Terzano C
Università Degli Studi La Sapieza Roma, Dipartamento di Scienze Cardiovascolari e Respiratorie.
Allergol Immunopathol (Madr). 1996 Mar-Apr;24(2):70-4.
We examined the resolution of the bronchial spasm induced by methacholine after administration of a dose sufficient to provoke PD20 to study, in patients with bronchial asthma, how spontaneous resolution (as opposed to bronchodilator-induced resolution) takes place. According to a randomization criterion, the patients were divided into four groups: 1) resolution induced by salbutamol (S), 2) by ipratropium bromide (I), 3) after placebo (P) and 4) spontaneous resolution (R). In brief, we observed that variations in FEV1 after methacholine PD20, reach statistically significant levels after 15 minutes in patients from groups (S) and (I), after 30 minutes in patients from groups (P) and (R) (p < 0.05). Comparing the phenomenon at various intervals in the four experimental situation, we found a pairing trend: groups (S) and (I) on the one hand, and groups (P) and (R) on the other. On the whole, this phenomenon shows that pharmacological treatment accelerates the process of spontaneous resolution of the bronchial spasm induced by methacholine which, in our experience, beings to show after 15 minutes, and that after 60 minutes, there are no statistically significant differences in the four groups. It is our opinion that closer examination of this phenomenon may provide greater knowledge of the mechanisms that come into play during the phase after stimulation of the muscarinic receptors and that reasonably involve the system to eliminate the muscarinic drug.
我们给予足以引发PD20的剂量的乙酰甲胆碱以诱发支气管痉挛,之后研究支气管哮喘患者中,支气管痉挛的自发缓解(与支气管扩张剂诱发的缓解相对)是如何发生的。根据随机化标准,患者被分为四组:1)沙丁胺醇(S)诱发的缓解组,2)异丙托溴铵(I)诱发的缓解组,3)安慰剂(P)后缓解组,4)自发缓解组(R)。简而言之,我们观察到,乙酰甲胆碱PD20后,(S)组和(I)组患者15分钟后FEV1的变化达到统计学显著水平,(P)组和(R)组患者30分钟后达到统计学显著水平(p < 0.05)。比较四种实验情况下不同时间间隔的现象,我们发现一种配对趋势:一方面是(S)组和(I)组,另一方面是(P)组和(R)组。总体而言,这一现象表明,药物治疗加速了乙酰甲胆碱诱发的支气管痉挛的自发缓解过程,根据我们的经验,该过程在15分钟后开始显现,并且60分钟后,四组之间无统计学显著差异。我们认为,对这一现象进行更深入的研究可能会让我们更深入地了解在毒蕈碱受体受刺激后的阶段中发挥作用的机制,这些机制合理地涉及消除毒蕈碱药物的系统。