哮喘患者进行糖皮质激素吸入治疗时吸气流速的作用
2009/07/09
背景：据报道：最近上市的手持式In-Check吸入装置可以检测哮喘患者的最大吸气流速（PIF），因此有助于检测PIF是否满足吸入装置的要求。本文主要研究吸入装置使用说明书以及各种类型可以检测PIF的吸入装置在哮喘患者中的作用。
目的：135名使用“准纳器”吸入氟替卡松或使用“都保”吸入布地奈德的哮喘患者入选本研究。
方法：使用In-Check吸入装置检测PIF。对于PIF不足50 L/min的患者给予说明书，吸入装置更换为hydrofluoroalkan-丙酸倍氯米松（HFA-BDP）。
结果：PIF与最大呼气流速显著相关（P < 0.0001）。给予说明指导后，仍有10名患者PIF不能达到50 L/min，因而更换为HFA-BDP，肺功能得到显著改善，包括FEV1（P = 0.018），PEF（P = 0.038），PEF50（P = 0.018）和PEF25（P = 0.011）。
结论：In-Check吸入装置检测PIF对于哮喘的临床治疗具有一定作用，不仅使用方便，而且能改善肺功能。
（陈欣 审校）
Respiration. 2009 May 19. [Epub ahead of print]
The Usefulness of Inspiratory Flow Rate during Inhalation Corticosteroid Therapy in Asthma.
Banno M, Ibata H, Niimi T, Sato S, Matsushita R.
Background: The recently released handheld In-Check device can be used to measure the peak inspiratory flow rate (PIF) of patients and is reportedly useful in determining whether the PIF is sufficient for using inhaler devices. In this study, we evaluated the effects of instructions for the use of the device and of the device type based on measurements of the PIF in asthma.
Background: The recently released handheld In-Check device can be used to measure the peak inspiratory flow rate (PIF) of patients and is reportedly useful in determining whether the PIF is sufficient for using inhaler devices. In this study, we evaluated the effects of instructions for the use of the device and of the device type based on measurements of the PIF in asthma.
Objectives: One hundred and thirty-five asthmatic patients who used a fluticasone propionate Diskus (FP-DK) or a budesonide Turbuhaler (BUD-TH) were studied.
Methods: The PIF was measured by the In-Check device. For patients without a sufficient PIF of 50 l/min, instructions for the use of the device were given, and the device was changed to hydrofluoroalkan-beclomethasone dipropionate (HFA-BDP).
Results: A significant correlation between the PIF and peak expiratory flow rate (p < 0.0001) was found. In 10 patients in whom the PIF did not increase to >50 l/min after instructions, the device was changed to HFA-BDP, which resulted in significant improvements in lung function in terms of the forced expiratory volume in 1 s (p = 0.018), peak expiratory flow (p = 0.038) and the maximum expiratory flow rates at 50% (p = 0.018) and 25% (p = 0.011).
Conclusions: Measurement of the PIF by the In-Check device is useful in the clinical management of asthma, to provide an appropriate device so as to improve lung function.
