特布他林对海水淹溺型肺水肿兔肺组织炎症反应的抑制作用

目的探讨特布他林对海水淹溺型肺水肿兔肺组织炎症反应的影响。方法36只机械通气的麻醉新西兰兔随机分成正常组（N组）、对照组（C组）和特布他林治疗组（T组）。C组和T组经颈动脉注入4ml／kg的配方海水，20min后C组经颈动脉注入2ml生理盐水，而T、组则注入0．15mg／kg特布他林，N组除未注入配方海水外，其余处理同C组。观察肺泡灌洗液（BALF）中TNF-α计量和中性粒细胞计数，取部分右下肺常规病理学检查，并分别用RT-PCR和ELISA检测肺组织中TNF-α、IL-1β和IL-8的mRNA表达及蛋白含量。结果病理学观察显示C组的肺组织内有大量的炎性细胞浸润，肺泡隔断裂、肺泡破裂、相互融合、肺泡大量萎陷，肺泡内有出血及透明膜形成。T组的上述改变轻于C组。T组肺组织内TNF-α、IL-1β和IL-8的mRNA表达及蛋白含量均显著低于C组（P〈0．05），BALF中TNF-α和中性粒细胞计数减少。结论特布他林可以抑制海水淹溺型肺水肿兔肺组织的TNF-α、IL-1β和IL-8，从而减轻肺组织炎症反应。     

β-Adrenergic agonists suppress chronic/relapsing experimental allergic encephalomyelitis (CREAE) in Lewis rats

Chronic/relapsing experimental allergic encephalomyelitis (CREAE) serves as an animal model for relapsing/remitting multiple sclerosis. Treatment with the β-adrenergic agonist isoproterenol or the β₂-adrenergic agonist terbutaline significantly suppressed both the first acute attack and the number of relapses in CREAE Lewis rats. The number of relapses was decreased even when treatment with β-adrenergic agonist was started after the onset of the first acute attack of CREAE. β-adrenergic receptor number was increased significantly on splenocytes from CREAE rats as compared to healthy controls or CFA-injected rats. Terbutaline treatment of CREAE rats lowered the splenocyte receptor number to normal values.     

Comparative effects ofβ 2-adrenoceptor agonists on intracranial self-stimulation,Sidman avoidance,and motor activity in rats

The effects of -adrenoceptor agonists were compared in various operant behavioral tasks, particularly intracranial self-stimulation (ICSS). Clenbuterol, salbutamol, and terbutaline all reduced responding by rats that lever-pressed for low stimulation intensities. The effects of clenbuterol in this test were completely reversed by propranolol, and those of salbutamol were partly reversed. Intermediate doses of clenbuterol and salbutamol slowed the initiation of rewarding brain stimulation in a shuttlebox but had little or no effect on the termination latencies. However, higher doses of both drugs lengthened the termination latencies. Motor activity was reduced at doses that attenuated ICSS responding. Complete tolerance occurred within 4 days to the effects of clenbuterol and salbutamol on leverpressing ICSS and to the effects of clenbuterol on motor activity. The apparent performance deficits induced by these drugs were overcome by more intense motivation. For example, even at high doses, clenbuterol reduced ICSS leverpressing only partially when animals bar-pressed for high rather than low stimulation intensities. Furthermore, all three drugs failed to alter Sidman avoidance responding at doses up to 100 times those that attenuated ICSS responding. It is concluded that although -adrenoceptor agonists cause apparent sedation in rats, this sedation is limited and shows rapid tolerance.     

足量布地奈德联合特布他林雾化吸入治疗毛细支气管炎疗效分析

目的：探讨足量布地奈德联合特布他林雾化吸入治疗小儿毛细支气管炎的疗效及安全性。方法：选取沂水中心医院儿科2011年10月至20]2年6月收治的毛细支气管炎患儿220例，随机分为足量布地奈德组（A组）90例、常规剂量布地奈德组（B组）90例和对照组（c组）40例。三组患儿均采取常规综合治疗，A组每次给予布地奈德混悬液1mg、特布他林雾化液1．5-25mg空气压缩泵雾化吸入，3次／天，病情好转后改为每次布地奈德n5nag、特布他林每次1．5—2．5mg空气压缩泵雾化吸入，2次／天，疗程5～7d；B组采用布地奈德每次0．5mg、特布他林每次1．5—2．5mg空气压缩泵雾化吸入，2次／天，疗程5—7d；C组只采用常规综合治疗。观察三组患儿症状、体征改善时间、静脉应用糖皮质激素时间及住院时间，记录不良反应。结果：A组与c组比较，A组显效率、总有效率、咳嗽消失时间、喘憋消失时间、哮鸣音消失时间、静脉应用激素时间及住院时间均优于c组（P均〈O．01）；A组与B组比较，除总有效率两组比较差异无统计学意义外（P〉0．05），其他指标A组均优于B组，差异有统计学意义（P〈0．05或P〈O．01）；B组与c组比较，B组上述指标均优于c组（P〈O．05或P〈O．01）；三组均未发现明显不良反应。结论：足量布地奈德联合特布他林雾化吸入治疗毛细支气管炎疗效显著，且安全、方便。     

特布他林注射液联合3%氯化钠雾化治疗小儿肺炎

目的：探讨特布他林注射液联合3%氯化钠雾化治疗小儿肺炎的临床疗效。方法按照随机数字表法将86例小儿肺炎患儿分为实验组和对照组，实验组患儿给予特布他林注射液联合3%氯化钠雾化吸入治疗，对照组患儿给予小儿肺热咳喘口服液治疗，比较两组临床疗效、用药期间不良反应、临床症状消失时间、体温恢复正常时间及治疗时间。结果实验组患儿治愈率和总有效率均显著高于对照组，差异有统计学意义（P＜0.05）；实验组患儿各临床症状消失时间、体温恢复正常时间及治疗时间均显著低于对照组，差异有统计学意义（P＜0.05）；两组患儿治疗期间均未发现明显不良反应。结论特布他林注射液联合3%氯化钠雾化治疗小儿肺炎治愈率高，能够迅速改善患儿临床症状和体征，缩短治疗时间，临床疗效显著。     

特布他林联合糖皮质激素治疗慢性阻塞性肺疾病急性加重期的疗效研究

目的：探讨特布他林联合糖皮质激素治疗慢性阻塞性肺疾病（ COPD）急性加重期的疗效。方法选取2011—2012年安新县医院收治的COPD急性加重期患者112例,随机分为观察组与对照组,各56例。对照组患者予以特布他林治疗,观察组患者在对照组基础上加用糖皮质激素治疗。观察两组患者动脉血气指标、临床疗效及呼吸困难分级。结果治疗前两组患者PaO2、PaCO2和pH值比较,差异无统计学意义（ P>0.05）,治疗后观察组患者PaO2和pH值高于对照组,PaCO2低于对照组,差异有统计学意义（P<0.05）;观察组患者临床疗效优于对照组（P<0.05）;治疗前两组患者呼吸困难分级比较,差异无统计学意义（ P>0.05）,治疗后观察组患者呼吸困难分级优于对照组（ P<0.05）。结论特布他林联合糖皮质激素治疗COPD急性加重期的疗效显著,可改善患者临床症状,提高生活质量。     

三拗片联合特布他林治疗咳嗽变异性哮喘的临床研究

目的探讨三拗片联合特布他林治疗咳嗽变异性哮喘的临床研究。方法选取2019年8月—2020年4月在青岛西海岸新区中医医院门诊急诊治疗的咳嗽变异性哮喘患者90例,随机分为对照组(n=45)和治疗组(n=45)。对照组经雾化器吸入硫酸特布他林雾化液,2.5mg/次,3次/d;治疗组在对照组治疗的基础上口服三拗片,2片/次,3次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组咳嗽症状的缓解和消失时间。比较两组嗜酸性粒细胞和肺功能的变化情况。结果治疗后,治疗组的总有效率95.56%,显著高于对照组的73.33%(P0.05)。治疗后,治疗组咳嗽缓解时间和咳嗽消失时间明显短于对照组(P0.05)。治疗后,两组患者血清中嗜酸性粒细胞水平明显低于治疗前水平(P0.05);治疗组治疗后血清中嗜酸性粒细胞水平显著低于对照组(P0.05)。治疗后,两组患者肺活量(FVC)、第1秒用力呼气量(FEV1)和最大呼气流量(PEF)明显高于治疗前(P0.05);治疗组治疗后FVC、FEV1和PEF显著高于对照组(P0.05)。结论三拗片联合特布他林治疗咳嗽变异性哮喘具有较好的临床疗效,能降低嗜酸性粒细胞水平,有效改善临床症状和肺功能指标,具有一定的临床推广应用价值。     

沙丁胺醇联合特布他林治疗支气管哮喘临床价值研究

目的探讨沙丁胺醇联合特布他林治疗支气管哮喘临床疗效及安全性。方法研究共计纳入130例支气管哮喘患者,均为我院2017年3月～2019年2月收治,采取随机数字表法将患者分为常规组与联合用药组,常规组患者予以常规治疗,联合用药组患者给予沙丁胺醇联合特布他林治疗,对比两组患者临床疗效、治疗前后症状积分及治疗后患者咳嗽、呼吸困难及哮鸣音等症状及体征消失时间、患者肺功能指标改善情况及治疗不良反应情况、治疗满意率情况。结果联合用药组治疗有效率高于常规组(P0.05);两组不良反应率均较低(P0.05);治疗后联合用药组患者症状积分优于常规组患者,且患者咳嗽、呼吸困难及哮鸣音等症状及体征消失时间短于常规组患者,肺功能指标优于常规组患者,差异有统计学意义(P0.05);联合用药组患者治疗满意率高于常规组(P0.05)。结论沙丁胺醇联合特布他林治疗支气管哮喘临床疗效均较高,患者症状及肺功能改善,不良反应少,安全可靠,患者满意率高。     

特布他林联合复方甲氧那明胶囊治疗咳嗽变异性哮喘的临床研究

目的探讨特布他林联合复方甲氧那明胶囊治疗咳嗽变异性哮喘的临床疗效。方法选取2016年1月—2017年1月在首都医科大学宣武医院治疗的咳嗽变异性哮喘患者86例,根据治疗方案的差别分为对照组(43例)和治疗组(43例)。对照组患者口服复方甲氧那明胶囊,2粒/次,3次/d。治疗组在对照组基础上雾化吸入硫酸特布他林雾化液,5 mg/次加入生理盐水2 m L,3次/d。两组患者均治疗4周。评价两组患者临床疗效,同时比较治疗前后两组患者临床症状评分、肺功能和血清学指标。结果治疗后,对照组患者总有效率为79.07%,显著低于治疗组的95.35%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者慢性咳嗽、咳痰、咽痒和喘息急促等临床症状积分均显著降低(P0.05);且治疗组临床症状评分比对照组更低(P0.05)。治疗后,两组患者第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)均显著增高(P0.05);且治疗组患者肺功能明显好于对照组(P0.05)。治疗后,两组患者血清白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)和降钙素原(PET)水平显著降低,白细胞介素-10(IL-10)和干扰素-γ(IFN-γ)水平显著升高,同组比较差异具有统计学意义(P0.05);且治疗组上述指标变化明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论特布他林联合复方甲氧那明胶囊治疗咳嗽变异性哮喘不仅能够有效改善临床症状和肺功能,还可改善血清相关炎性因子水平,具有一定的临床推广应用价值。     

In vitro study and semiempirical model for aerosol delivery control during mechanical ventilation

The object of this study was to evaluate in vitro the influence of various ventilatory parameters on the delivery of synchronized nebulization of terbutaline during mechanical ventilation and to determine a semiempirical model to control the quantity of aerosol delivered into the patients lung. An ATOMISOR NL9 M jet nebulizer (La Diffusion Technique Française, France) was filled with terbutaline (Bricanyl, Astra-Zeneca, Sweden) and connected to the inspiratory line of a Horus ventilator (Taema, France). Nebulization was synchronized with the inspiratory phase. We assessed at the end of the endotracheal tube the quantity of terbutaline (terbutaline mass output) and the volume median diameter (VMD) by diffraction-laser method. There was a negative correlation between terbutaline mass output and inspiratory air flow ( r =–0.95, p <0.0001) and between VMD and inspiratory air flow ( r =–0.96, p <0.0001). Moreover, positive end-expiratory pressure levels between 0 cm and 8 cm of water did not significantly change the terbutaline output mass ( p =0.22). Total nebulization time and terbutaline mass output calculated by the mathematical model showed good agreement with experimental data. In conclusion, our semiempirical model allows calculation of the duration of the nebulization required to deliver a given mass of terbutaline into patient lungs.This revised version was published online in May 2005 with a corrected section heading.