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沙美特罗可减轻慢性阻塞性肺疾病(COPD)患者的呼吸困难并改善其肺功能。

Salmeterol reduces dyspnea and improves lung function in patients with COPD.

作者信息

Ramirez-Venegas A, Ward J, Lentine T, Mahler D A

机构信息

Department of Medicine, Dartmouth Medical School, Lebanon, NH 03756-0001, USA.

出版信息

Chest. 1997 Aug;112(2):336-40. doi: 10.1378/chest.112.2.336.

Abstract

STUDY OBJECTIVE

To investigate the short-term effects of inhaled salmeterol on the perception of dyspnea and lung function in patients with COPD.

DESIGN

Double-blind, crossover, randomized trial comparing inhaled salmeterol and inhaled placebo over 4 h.

SETTING

Pulmonary function laboratory at university medical center.

PATIENTS

Sixteen patients with symptomatic COPD and at least 200-mL increase in FEV1 after inhalation of two puffs (180 microg) of albuterol.

INTERVENTIONS

Visit 1 was used for familiarization. At visits 2 and 3 (2 to 3 days apart), patients inhaled either two puffs of salmeterol (42 microg) or placebo.

MEASUREMENTS AND RESULTS

Lung function and dyspnea were measured at 0.5, 2, and 4 h after inhalation of the study medication. Dyspnea was measured by the -5 to +5 category scale at rest and by the 0 to 10 category-ratio scale while breathing through inspiratory resistances of 5, 15, and 30 cm H20/L/s. Age was 66+/-8 years (mean+/-SD). FEV1 was 0.97+/-0.331 (51+/-13% predicted). There were significantly higher values for FEV1 and FVC (at all time periods) and lower values for functional residual capacity (at all time periods) and residual volume (at 4 h) with salmeterol than with placebo. There were significantly lower dyspnea ratings on the -5 to +5 category scale (p=0.03 at 2 h and p=0.02 at 4 h) and for the mean dyspnea scores during resistive breathing with salmeterol compared with placebo (p=0.002).

CONCLUSIONS

Inhaled salmeterol reduced dyspnea, increased airflow, and reduced hyperinflation over 4 h in patients with symptomatic COPD.

摘要

研究目的

探讨吸入沙美特罗对慢性阻塞性肺疾病(COPD)患者呼吸困难感知及肺功能的短期影响。

设计

双盲、交叉、随机试验,比较吸入沙美特罗和吸入安慰剂4小时的效果。

地点

大学医学中心的肺功能实验室。

患者

16例有症状的COPD患者,吸入两喷(180微克)沙丁胺醇后FEV1至少增加200毫升。

干预措施

第1次就诊用于熟悉流程。在第2次和第3次就诊(间隔2至3天)时,患者吸入两喷沙美特罗(42微克)或安慰剂。

测量指标及结果

吸入研究药物后0.5、2和4小时测量肺功能和呼吸困难情况。通过-5至+5等级量表测量静息时的呼吸困难,通过0至10等级比例量表测量在吸气阻力为5、15和30厘米水柱/升/秒时呼吸时的呼吸困难。年龄为66±8岁(均值±标准差)。FEV1为0.97±0.331(预测值的51±13%)。与安慰剂相比,沙美特罗组在所有时间段的FEV1和FVC值显著更高,功能残气量(所有时间段)和残气量(4小时时)值更低。与安慰剂相比,沙美特罗组在-5至+5等级量表上的呼吸困难评分显著更低(2小时时p = 0.03,4小时时p = 0.02),且在阻力呼吸期间的平均呼吸困难评分也更低(p = 0.002)。

结论

对于有症状的COPD患者,吸入沙美特罗在4小时内可减轻呼吸困难、增加气流并减少肺过度充气。

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