静脉输注甘露醇可降低哮喘患者气道对乙酰甲胆硷的反应性
2007/06/27
Valerio等观察了静脉输注甘露醇对哮喘和COPD患者气道反应性的影响。研究基于哮喘和COPD患者以气道炎症和水肿为特征，气道壁的水肿通过增加气道厚度、改变气道的顺应性、或损害气道平滑肌对肺弹性回缩的信息传递而导致气腔狭窄、气道高反应性。作者推测静脉输注甘露醇（一种高渗利尿剂），可能通过减少哮喘和COPD患者气道壁的水含量，降低气道对乙酰甲胆硷的反应性。8例哮喘和6例COPD患者在输注甘露醇前后检测气道对乙酰甲胆硷的反应性、肺容积、肺力学指标等，结果发现甘露醇可降低哮喘患者气道对乙酰甲胆硷的反应性和肺弹性回缩的损害，COPD患者无明显变化。
因此，作者认为哮喘患者气道壁水肿对气道反应性有影响，甘露醇对哮喘和COPD作用不同，与疾病的特殊病理特征有关。
（刘晓菊 兰州医学院第一附属医院呼吸科 730000 摘译）
(Respir Physiol Neurobiol. 2007 ;156:374-377)
Valerio G, Salerno FG, Bracciale P The i.v. infusion of mannitol decreases airway responsiveness to methacholine in asthma.
Respir Physiol Neurobiol. 2007 Jun 15;156(3):374-7.
Respir Physiol Neurobiol. 2007 Jun 15;156(3):374-7.
Divisione di Pneumologia, Ospedale "Ninetto Melli", San Pietro Vernotico, Via Lecce 246-72027, San Pietro Vernotico, Brindisi, Italy.
Bronchial asthma and chronic obstructive pulmonary disease (COPD) are characterized by airway inflammation and oedema. The oedema of the airway wall may contribute to airway narrowing and hyperresponsiveness by increasing airway wall thickness, by altering airway compliance, or by impairing the transmission of the lung elastic recoil to the airway smooth muscle (ASM). We hypothesized that the i.v. infusion of mannitol, an osmotic diuretic, would reduce the water content of the airway wall in asthma and COPD, thus decreasing airway responsiveness to methacholine (MCh). In eight asthmatic and in six COPD patients, airway responsiveness to MCh, lung volumes and lung mechanics were measured before and after infusion of mannitol. In the asthmatics, mannitol decreased airway responsiveness to MCh and lung elastic recoil. In the COPD patients, no differences were recorded after mannitol infusion. These data suggest that the airway wall oedema, in asthma, has an impact on airway responsiveness to MCh. The differential effect of mannitol in asthma versus COPD, may relate to the specific pathologic features of the diseases.
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β2受体多态性和哮喘表型：与被动吸烟的关系
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血管生成素Ⅰ和血管生成素Ⅱ对哮喘患者气道血管通透性的作用
