Siffredi M, Mastropasqua B, Pelucchi A, Chiesa M, Marazzini L, Foresi A
Servizio di Fisiopatologia Respiratoria G Campari Modulo di Allergologia ed Immunopatologia Polmonare, Italy.
Ann Allergy Asthma Immunol. 1997 Feb;78(2):238-43. doi: 10.1016/S1081-1206(10)63395-9.
Inhaled furosemide has been shown recently to produce a protective effect against bronchoconstriction induced by several indirect stimuli, including ultrasonically nebulized distilled water (UNDW). Since there is a close parallel between its experimental effects and those reported for cromolyn,/it has been suggested that they may share some common mechanisms of action. Their protective effect, however, has never been compared directly. In this study, therefore, we have investigated the ability of equal doses (30 mg) of inhaled furosemide and cromolyn to modulate bronchoconstriction induced by UNDW in a group of ten asthmatic patients.
Subjects with documented bronchial response to UNDW were enrolled in a randomized, double-blind, placebo-controlled study. Treatments were administered five minutes prior to increasing outputs of UNDW and the response was expressed as the provocative output causing a 20% fall in FEV1 (PO20, in mL/min) and as the output-response slope.
Geometric mean PO20 increased from 1.53 to 4.05 mL/min (P < .0004) after furosemide. After inhaling the highest output of UNDW (5.2 mL/min), PO20 was not measurable in six of ten patients when pretreated with furosemide and in all patients when pretreated with cromolyn. This difference was statistically significant (P < .05). Geometric mean values of output-response slope significantly decreased from 13.6 to 2.97 after furosemide (P < .0001) and from 13.6 to 1.43 (P < .0002) after cromolyn.
These results suggest that cromolyn has a slightly greater anti-reactive activity in UNDW-induced bronchoconstriction compared to furosemide.
最近研究表明，吸入性速尿对多种间接刺激诱导的支气管收缩具有保护作用，这些间接刺激包括超声雾化蒸馏水（UNDW）。由于其实验效果与色甘酸钠的实验效果极为相似，因此有人提出它们可能具有一些共同的作用机制。然而，它们的保护作用从未进行过直接比较。因此，在本研究中，我们调查了10名哮喘患者吸入等量（30毫克）速尿和色甘酸钠调节UNDW诱导的支气管收缩的能力。
将对UNDW有支气管反应记录的受试者纳入一项随机、双盲、安慰剂对照研究。在增加UNDW输出量前5分钟给予治疗，反应以引起第一秒用力呼气容积（FEV1）下降20%的激发输出量（PO20，单位为毫升/分钟）和输出-反应斜率表示。
速尿治疗后，几何平均PO20从1.53毫升/分钟增加到4.05毫升/分钟（P < .0004）。吸入最高输出量的UNDW（5.2毫升/分钟）后，速尿预处理的10名患者中有6名患者的PO20无法测量，色甘酸钠预处理的所有患者的PO20均无法测量。这种差异具有统计学意义（P < .05）。速尿治疗后输出-反应斜率的几何平均值从13.6显著降至2.97（P < .0001），色甘酸钠治疗后从13.6降至1.43（P < .0002）。
这些结果表明，与速尿相比，色甘酸钠对UNDW诱导的支气管收缩具有略强的抗反应活性。
