Anderson S D, Brannan J, Spring J, Spalding N, Rodwell L T, Chan K, Gonda I, Walsh A, Clark A R
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia.
Am J Respir Crit Care Med. 1997 Sep;156(3 Pt 1):758-65. doi: 10.1164/ajrccm.156.3.9701113.
We developed a bronchial provocation test (BPT) with a dry powder preparation of mannitol. The mannitol was inhaled from gelatin capsules containing 5, 10, 20, or 40 mg to a cumulative dose of 635 mg, and was delivered via an inhalator, Halermatic, or Dinkihaler device. We studied the airway sensitivity to inhaled mannitol, the repeatability of the response, and the recovery after challenge in 43 asthmatic subjects 18 to 39 yr of age who had a 20% decrease in FEV1 in response to inhaling a 4.5% NaCl. We compared this with the airway response to methacholine in 25 subjects. The geometric mean (GM) for the dose of dry mannitol required to reduce the FEV1 by 15% of the baseline value (PD15) was 64 mg, with a 95% confidence interval (CI) of 45 to 91. Subjects responsive to mannitol had a PD20 to metacholine of < 7.8 mumol, with a GM of 0.7 mumol (CI: 0.4 to 1.2). For the first of two challenges to mannitol the PD15 was 59 mg (CI: 36 to 97) and for the second the PD15 was 58 mg (CI: 35 to 94) p = 0.91 (n = 23). Spontaneous recovery to within 5% of baseline occurred within 60 min and within 10 min after 0.5 mg terbutaline sulfate was inhaled. Arterial oxygen saturation (SaO2) remained at 93% or above during mannitol challenge. Subjects tolerated the inhalation of the mannitol well. A dry powder preparation of mannitol may be suitable to develop for bronchial provocation testing.
我们研发了一种使用甘露醇干粉制剂的支气管激发试验（BPT）。从含有5、10、20或40毫克的明胶胶囊中吸入甘露醇，累积剂量达635毫克，并通过Halermatic吸入器或Dinkihaler装置输送。我们研究了43名18至39岁哮喘患者对吸入甘露醇的气道敏感性、反应的可重复性以及激发后的恢复情况，这些患者吸入4.5%氯化钠后FEV1下降20%。我们将此与25名受试者对乙酰甲胆碱的气道反应进行了比较。使FEV1降低至基线值的15%（PD15）所需的甘露醇干粉剂量的几何平均值（GM）为64毫克，95%置信区间（CI）为45至91。对甘露醇有反应的受试者对乙酰甲胆碱的PD20<7.8微摩尔，GM为0.7微摩尔（CI：0.4至1.2）。对于甘露醇的两次激发中的第一次，PD15为59毫克（CI：36至97），第二次PD15为58毫克（CI：35至94），p = 0.91（n = 23）。吸入0.5毫克硫酸特布他林后，60分钟内或10分钟内自发恢复至基线的5%以内。甘露醇激发试验期间动脉血氧饱和度（SaO₂）保持在93%或以上。受试者对吸入甘露醇耐受性良好。甘露醇干粉制剂可能适合用于支气管激发试验的研发。
