复方异丙托溴铵对支气管哮喘重度急性发作初始治疗的作用  

Effect of ipratropium compound in the initial treatment of patients with severe acute asthma exacerbation

作　　者：李道海[1] 梁子敬[1] 林锦潮[1] 彭翔[1] 

机构地区：[1]广州医学院第一附属医院急诊科,广东广州510120

出　　处：《海南医学》2012年第1期12-14,共3页Hainan Medical Journal

摘　　要：目的评价复方异丙托溴铵反复雾化吸入治疗支气管哮喘(简称"哮喘")重度急性发作初始的即刻疗效。方法 106例哮喘重度急性发作患者随机分为治疗组和对照组,对照组使用沙丁胺醇2.5mg,治疗组使用复方异丙托溴铵1支(内含沙丁胺醇2.5mg和异丙托溴铵0.5mg),每20min雾化吸入一次,连续3次。两组患者都常规吸氧、静脉应用糖皮质激素甲强龙120mg。治疗前和开始治疗后35min、70min和120min,评估患者血压、心率、呼吸频率和脉搏血氧饱和度等生命体征变化以及症状缓解情况。结果与治疗前相比,治疗组和对照组患者生命体征都有明显好转(P<0.05);治疗组和对照组患者症状缓解率,在开始治疗后35min缓解率分别为57.4%和36.5%(P<0.05),70min时为79.6%和61.5%(P<0.05);120min时为88.9%和86.5%(P>0.05);两组均无明显的不良反应。结论对哮喘重度急性发作患者初始治疗时,反复雾化吸入复方异丙托溴铵(沙丁胺醇+异丙托溴铵),能更迅速有效缓解患者的临床症状,优于单独使用沙丁胺醇。Objective To evaluate the immediate effect of repetitive nebulized ipratropium compound in the initial treatment of adult patients with severe acute asthma exacerbation. Methods A total of 106 patients presenting with severe acute asthma exacerbation were enrolled. Subjects were randomized to receive nebulizer treatmants with either 2.5 mg of a[buterol （control group） or one dose of ipratropium compound （2.5 mg of albuterol mixed with 0.5 mg of ipratropium bromide, treatment group） every 20 minutes for three times. All patients received supplemental oxygen and methylprednisolone, 120 rag, IV. Vital signs, pulse oximetry and rates of symptom remission were measured before and at 35, 70 and 120 rain after initiation of nebulizer treatments. Results There was significant improvement in vital signs between two groups at 120 minutes compared with baseline before nebulizer treatments （P〈 0.05）. The rates of symptom remission in treatment and control group at 35 rain were 57.4% versus 36.5% （P〈0.05）, 79.6% versus 61.5%（P〈0.05）at 70 rain, 88.9% versus 86.5%（P〉0.05）at 120 rain,respectively. There was few side effects in both two groups. Conclusion The use of nebulized ipratropium compound （albuterol plus ipratropium） resuited in a more rapid and more effective therapeutical effect in the initial treatment of adult patients with severe acute asthma exacerbation compared with albuterol alone.

关 键 词：异丙托溴铵 沙丁胺醇 支气管哮喘 

分 类 号：R562.2[医药卫生—呼吸系统]