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目的:比较慢性阻塞性肺疾病(COPD)患者吸入200μg沙丁胺醇与吸入80μg溴化异丙托品进行支气管舒张试验结果的一致性。方法:采用随机、交叉、自身对照的方法观察40例COPD患者吸入200μg沙丁胺醇、80μg溴化异丙托品进行支气管舒张试验,比较1秒钟用力呼气容积(FEV1)绝对值改变量、FEV1改变率、弥散(DLCO)改变率、气道阻力(Raw)改变率、峰呼气流速(PEF)改变率、舒张试验阳性率。结果:COPD患者吸入200μg沙丁胺醇或吸入80μ9溴化异丙托品进行支气管舒张试验,FEV1绝对值改变量、FEV1改变率、DLCO改变率、Raw改变变率、PEF改变率、舒张试验阳性率差异无显著性。急性发作期COPD患者FEV1绝对值改变量、FEV1改变率、舒张试验阳性率均高于稳定期COPD患者,差异显著(P<0.01)。结论:吸入200μg沙丁胺醇、80μg溴化异丙托品具有相同的舒张试验的效能。对于吸入沙丁胺醇有禁忌的患者行支气管舒张试验时,吸入80μg溴化异丙托品是一理想的选择。
PURPOSE: To compare the consistency of bronchodilator test results between patients receiving inhaled 200 μg salbutamol and inhaled 80 μg ipratropium bromide in patients with chronic obstructive pulmonary disease (COPD). Methods: Bronchodilator test was performed in 40 patients with COPD by inhalation of 200 μg salbutamol and 80 μg ipratropium. The FEV1 absolute changes were compared with the changes of FEV1 Rate of change of diffusion (DLCO), change of airway resistance (Raw), change of peak expiratory flow rate (PEF) and positive rate of diastolic test. Results: Bronchodilator test was performed in patients with COPD by inhalation of 200μg salbutamol or inhalation of 80μ9 ipratropium. The FEV1 absolute change, FEV1 change, DLCO change, Raw change rate, PEF change rate, and diastolic test positive rate difference Significance. The change of absolute FEV1, the change of FEV1 and the positive rate of diastolic test in patients with acute exacerbation of COPD were significantly higher than those in stable COPD patients (P <0.01). Conclusion: Inhalation of 200 μg of salbutamol and 80 μg of ipratropium bromide demonstrated the same diastolic efficacy. In patients with contraindications to inhalation of albuterol bronchodilator test, inhalation of 80μg ipratropium bromide is an ideal choice.