盐酸戊乙奎醚对机械通气慢性阻塞性肺疾病患者的支气管扩张作用  

Bronchodilation induced by penehyclidine hydrochloride in chronic obstructive pulmonary disease patients undergoing mechanical ventilation

作　　者：徐伟[1] 车在前[1] 陆一鸣[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院急诊科,上海200025

出　　处：《世界临床药物》2010年第11期665-668,共4页World Clinical Drug

摘　　要：目的观察盐酸戊乙奎醚对采用机械通气的慢性阻塞性肺疾病(COPD)患者的支气管扩张作用。方法选择10例应用机械通气的COPD急性加重期患者,雾化吸入盐酸戊乙奎醚1 mg,记录患者给药前后呼吸力学参数、血气分析及心率,并对给药前后的各组数据进行比较。结果患者的气道峰压、吸气阻力和内源性呼气末正压存给药后15 min即明显下降、肺顺应性明显增加;至3 h时,变化最显著;至12 h时,差异仍有统计学意义(P<0.05)。用药前后,患者的动脉血氧分压、动脉血氧饱和度和心率无显著变化,而动脉血二氧化碳分压较用药前下降(P<0.05)。支气管扩张的持续时间平均在9h。结论盐酸戊乙奎醚有助于机械通气COPD患者持续的支气管扩张,且无明显心血管方面的不良反应。Objective To evaluate bronchodilation induced by penehyclidine hydrochloride in chronic obstructive pulmonary disease （COPD） patients undergoing mechanical ventilation. Methods Ten patients with acute exacerbation of COPD and undergoing mechanical ventilation were treated with 1 mg nebulized penehyclidine hydrochloride. Respiratory mechanical parameters, blood gas analysis and heart rate were measured before and after penehyclidine hydrochloride administration. These data were analyzed by nonparametric Wilcoxon signed rank test. Results Significant reduction of Peak airway pressure （Ppeak）, intrinsic positive end-expiratory pressure （PEEPi） and inspiratory resistance （Rinsp）, and increase of end-inspiratory static compliance of the respiratory system （Cst,rs） were observed as early as 15 minutes after the treatment. The effectiveness reached the maximum at 3 hours and remained significant up to 12 hours after the treatment. Compared with before treatment, PaO2, SaO2 and heart rate of after treatment had no significant change, while PaCO2 decreased. The bronchodilation effects lasted nine hours in average. Conclusion In COPD patients undergoing mechanical ventilation, penehyclidine hydrochloride delivered by nebulization can significantly induce bronchodilation with minor adverse effects on cardiovascular system.

关 键 词：盐酸戊乙奎醚 慢性阻塞性肺疾病 机械通气 支气管扩张 

分 类 号：R971.92[医药卫生—药品] R563.4[医药卫生—药学]