M胆碱受体拮抗药对慢性阻塞性肺疾病患者呼吸肌功能的影响  

The effect of M-receptor antagonist on the function of respiratory muscle in the patients with COPD

作　　者：刘广杰[1] 卓婕[1] 王扬[1] 罗秀芳[1] 胥杰[1] 陆吉贤[1] 

机构地区：[1]首都医科大学附属北京同仁医院呼吸内科,北京100730

出　　处：《中国医刊》2009年第6期30-32,共3页Chinese Journal of Medicine

摘　　要：目的探索COPD患者的呼吸肌和外周肌肉的功能状态,评价M胆碱受体拮抗药对呼吸肌肉功能的影响。方法对22例COPD患者和22例健康对照者测定静态肺功能和最大吸气压力和最大呼气压力,行运动负荷试验,以无创气体交换方法求取无氧阈。COPD患者予以异丙托溴铵气雾剂每日120μg,分3次吸入,4周后再次测定肺功能和呼吸肌力指标。结果 COPD组的PI max为4.8±2.1kPa,低于健康人组的PI max7.1±2.4kPa;PEmax为7.2±3.9kPa,与健康人组的PEmax7.6±3.5kPa没有差别;AT为15.8±3.5 ml/(min·kg),低于健康人组19.6±3.1 ml/(min·kg)。COPD患者吸入异丙托溴铵气雾剂4周前后FEV,分别为1.48±0.39L,1.61±0.43L;V_(50)分别为0.88±0.22L/min,1.21±0.31L/min;PImax分别为4.8±2.1kPa,5.9±2.0kPa,均明显改善。结论 COPD患者不仅存在着肺部阻塞性通气功能降低,也存在呼吸肌肉和外周肌肉的功能降低,最大吸气压力PI max和无氧阈AT可以作为康复运动设计的呼吸生理学指标。M胆碱受体拮抗药能有效改善COPD患者的肺功能和呼吸肌功能。Objective COPD is characterized with its not only a lung disease but also is a systemic disease. The aims of this study are to study the function status of respiratory muscle ＆ peripheral muscle; and to investigate the effect of M-receptor antagonist on the function of respiratory muscle in the patients with COPD. Methods 22 patients with COPD and 22 health controls were recruited in this study. Static pulmonary function, Maximum inspiratory pressure （ PI max）, and Maximuan expiratory pressure （PE max）, were measured; as well as exercise test was performed. ：~naernbic Threshold （AT） was taken by the method of non-invasive gas exchange. Ipratropium Bromide Aerosol was administrated to the patients with COPD by inhalation （120μg/day, rid） for 4 weeks, the pulmonary function and the parameters of respiratory muscle function were measured before and after administration of Ipratropium Bro- mide in the patients with COPD. Results PI max in the patients with COPD is significantly reduced compared with the healthy controls; there is no significant different in PEmax between in the patients with COPD and healthy controls; AT in the patients with COPD is significantly decreased than healthy controls. Administration of Ipratropium Bromide significantly improve FEV1 and V50 in the patients with COPD; also Ipratropium Bromide inhalation significantly increase Plmax in the patients with COPD. Conclusion In patients with COPD, not only respiratory function is reduced due to obstructive limitation of airway but also presenting a decrease of function of respiratory muscle and peripheral muscle. These eompose an integrated reason of reduction of exercise function in patients with COPD. PI max and AT could be designated as indicators of respiratory physiology in the design of pulmonary rehabilitation. M-receptor antagonist could significantly improve pulmonary function and respiratory muscle function in the patients with COPD, with an importantly clinical significance.

关 键 词：COPD 最大吸气压力 无氧阈 M胆碱受体拮抗药 

分 类 号：R561[医药卫生—呼吸系统]