沙丁胺醇、异丙基肾上腺素在支气管舒张试验测定中的作用比较

目的　比较沙丁胺醇 (喘乐宁 )、异丙基肾上腺素 (异丙肾 )在支气管舒张试验中的作用及对支气管哮喘的诊断与鉴别诊断的价值。方法　采用随机交叉自身对比方法 ,对 5 9例哮喘和 37例 COPD患者按单、双日交叉吸入上述两药 ,并测定其肺功能改变率及达阳性标准例数。结果　无论 COPD或哮喘组 ,同一病人吸入西药后其肺功能改变率呈直线正相关 (P<0 .0 5 ) ,但哮喘组吸入沙丁胺醇后 FEV1 、MMEF、Raw、s Gaw改变率显著强于异丙肾(P<0 .0 2 ) ,哮喘组 FVC、PEF改变率以及 COPD上述各项改变率两药物间比较无显著性差异 (P>0 .10 )。分别吸入沙丁胺醇、异丙肾后 ,两组病人舒张试验的各项指标达到阳性标准的例数均有明显差异 (P<0 .0 0 5 ) ,尤其是哮喘组以沙丁胺醇为吸入药物时 ,s Gaw阳性检出率高达 98% ,而 COPD阳性检出率普遍较低。结论　舒张试验对哮喘的诊断价值明显。舒张试验用沙丁胺醇作舒张剂效果显著优于异丙肾。s Gaw是舒张试验中最敏感的评定指标 ,其余依次为FEV1 (92 % )、MMEF、Raw,而 FVC、PEF阳性率较低

A Comparison Between the Effects of Albuterol and Isoproterenol in Bronchodilation Test

Objective To compare albuterol with isoproterenol as a bronchodilator in pulmonary function test and their value in the diagnosis and differential diagnosis of asthma. Methods Two groups (59 patients with asthma and 37 patients with COPD) were included in this study, and the patients of each group were randomly divided into 2 subgroups. The patients in the 2 subgroups inspired the two drugs in a cross over by odd or even days. The pulmonary functions were evaluated. Results The changing rates of pulmonary functions induced by the two drugs in the two groups were positively correlated( P< 0.005), The changing rates of FEV 1,MMEF,Raw,sGaw induced by albuterol were higher than the ones induced by isoproterenol in patients with asthma( P <0 02),however the changing rates of FVC and PEF in asthma cases and all the above parameters in COPD cases were not significantly different between the two drugs( P >0.10). The comparison of positive case number between asthma and COPD cases induced by both drugs showed significant difference( P <0.005); especially, when the positive rate of sGaw induced by albuterol in asthma cases reached 98%, the positive rates in COPD cases was generally much lower. Conclusion Bronchodilation test is a valuable diagnostic method for asthma. In this study, albuterol was superior to isoproterenol. The most sensitive index in bronchodilation test was sGaw, then in order, FEV 1(92%),MMEF and Raw; the FVC and PEF were relatively insensitive.