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題名 | Effect of Nebulized Fenoterol on Spirometry, Dyspnea Sensation Changes during Exercise in Patients with Chronic Obstructive Pulmonary Disease=Fenoterol噴霧治療對慢性阻塞型肺疾忠者運動時之肺功能、氣喘感覺的影響 |
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作者 | 江玲玲; 余志騰; 郭漢彬; | 書刊名 | 長庚醫學 |
卷期 | 19:2 1996.06[民85.06] |
頁次 | 頁129-134 |
分類號 | 415.415 |
關鍵詞 | 氣喘感覺; 肺助能; 運動量; 擬交感神經支氣管擴張制; 慢性阻塞型肺炎; Dyspnea; Pulmonary function; Exercise capacity; Betamimetic bronchodilator; COPD; |
語文 | 英文(English) |
中文摘要 | 氣道之氣流受阻會使慢性阻塞型肺疾患者之運動量減低。支氣管擴張劑已被發現可以增進此類患者之運動耐力但其機轉仍不是很清楚。於16位中度至嚴重度的慢性阻塞型肺疾患者,我們先給予生理食鹽水吸入(控制組)後作6分鐘行走測式,60分鐘作作fenterol溶液噴霧治療。同樣的亦接著鷹行走測試,以此方式研究fenterol於行走運動時的效果。每次行走測試前後皆作肺功能(FEV1用力呼氣第一秒容積;FVC用力呼氣肺活量),血氧飽含度及氣喘指數(Borg氣喘分數,BS)的測量。與生理食鹽水噴霧對照比較,FENTOEROL對運動前的肺功能無顯著影響,但運動後的FEV1(0.9±0.1L,p<0.0001)及FVC(2.0±0.2L,p<0.01)皆較高,且有顯著差異。走完6分鐘後其FEV1降低較多者,吸完fenoterol後其走路距離增進較多,兩者呈顯著的反比關係(r=-0.74,p<0.002)。吸完fenoterol後,能走的愈遠者但並不會覺得喘,且呈顯著的反比關係(r=-0.61,p<0.02)。由以上這些結果,我們建議fenoterol對慢性阻塞型肺疾患者也許可以藉著減低運動時氣道氣流受阻的現象的而增進其運動耐力。我們亦建議6分鐘行走測試可作為慢性阻塞型肺疾患者之例行臨床評估,以能評估擬交感神經支氣管擴張劑的症狀改善效果。 |
英文摘要 | Airflow imitation impairs exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Bronchodilators have been shown to increase exercise tolerance in patients with COPD by mechanisms yet unclarified. We studied the effect of nebulized fentoerol (0.5mg/ml) on the 6-minute walking test (WT) 60 mins after a control WT using a nebulized saline control in 16 patients with moderate to severe COPD. Before and immediately after each WT, the FEV1, FVC, O2 Sturation and dyspnea seore (Borg breathlessness score, [BS]) were measured. Fenoterol had no significant effect on pre-exercise spirometry in our patients but maintained a significantly higher level of EFV1 (0.9±0.1L, p<0.0001) and FVC (2.0±0.2L, p<0.01) immediately after exercise than that after saline control nebulization (0.7±0.1L, 1.8±0.2L, respectively). Fenoterol significantly (p<0.01) increased walking distance (WD) from 201.3±22.2m to 238.9±22.2m, but no difference was found in BS and oxygen saturation. The decline in FEV1 following the WT was shown to have an inverse relationship (r=-0.74, p<0.002) with the WD improvement (△WD). Those who walked farther after fenoterol inhalation felt less dyspnea after exercise, also with an inverse correlation (r=-0.61, p<0.02). These results suggest that fenoterol may improve exercise capacity by preventing airflow deterioration during exercise in patients with COPD. We also recommend the 6-minute walking test in the routine clinical assessment of COPD patients to evaluate the symptomatic benefit offered by betamimetic bronchodilators. |
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