Sadiq S A, Fielding K, Vernon S A
Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK.
Eye (Lond). 1998;12 ( Pt 3a):386-9. doi: 10.1038/eye.1998.91.
Recently, attention has been focused on the adverse drug reactions of topical timolol, especially with regard to respiratory function in the elderly. This study was designed to assess whether timolol causes an alteration in lung function in patients without pre-existing respiratory disease and who have not suffered the impact of long-term beta 2 blockade.
A placebo-controlled randomised, double-masked, cross-over study was carried out on 20 ocular hypertensive patients with intraocular pressures over 21 mmHg, normal optic discs and full visual fields by Humphrey perimetry. Subjects received single-dose units of timolol maleate 0.5% drops or normal saline drops. Both were instilled in one eye or systemically (sublingually). The peak expiratory flow rate (PFR), forced expiratory volume (FEV), vital capacity (VC) and FEV/VC (%) ratio were all measured both before and after each type of drop and route of administration.
Two hours after instillation of timolol there was no change in PFR (p = 0.67) or VC (p = 0.40), but there was a fall in FEV (p = 0.038) and the FEV/VC (%) ratio (p = 0.041). The fall was greatest after topical administration.
Our results show that in our group of patients there was a tendency towards mild bronchial obstruction after topical timolol, although this was not clinically significant.
最近，局部用噻吗洛尔的药物不良反应受到关注，尤其是对老年人呼吸功能的影响。本研究旨在评估噻吗洛尔是否会使无既往呼吸系统疾病且未受到长期β2受体阻滞剂影响的患者的肺功能发生改变。
对20例眼压高于21 mmHg、视神经盘正常且经Humphrey视野计检查视野完整的高眼压患者进行了一项安慰剂对照的随机、双盲、交叉研究。受试者接受单剂量单位的0.5%马来酸噻吗洛尔滴眼液或生理盐水滴眼液。两种药物均滴入一只眼或全身给药（舌下给药）。在每种滴眼液及给药途径前后均测量呼气峰值流速（PFR）、用力呼气量（FEV）、肺活量（VC）和FEV/VC（%）比值。
滴入噻吗洛尔两小时后，PFR（p = 0.67）或VC（p = 0.40）无变化，但FEV（p = 0.038）和FEV/VC（%）比值（p = 0.041）下降。局部给药后下降最为明显。
我们的结果表明，在我们的患者组中，局部使用噻吗洛尔后有轻度支气管阻塞的倾向，尽管这在临床上并不显著。
