Regadenoson（瑞加德松）在轻/中度慢性阻塞性肺病和哮喘患者中的安全性比较研究
2013/09/12
摘要
目的：比较一种选择性A2A腺苷受体拮抗剂——Regadenoson（瑞加德松），联合低水平运动，对进行心肌灌注显像（MPI）的轻/中度慢性阻塞性肺病和哮喘患者中的安全性。
方法：我们研究了116例患者，其中COPD 67例，哮喘49例（男性62%，平均年龄68.3 ± 11.3岁，范围31～87岁）。患者人口统计、病史、用药、压力下临床症状以及血压（BP）、心率（HR）变化都予以评估。
结果：除了COPD组使用抗胆碱药的患者比例更高，以及哮喘组使用抗白三烯调节剂的患者比例更高（分别为58.2% vs. 28.6% 和 1.5% vs. 14.3%；所有p<0.01），两组患者在高血压、血脂异常、糖尿病和用药方面均类似。COPD患者中呼吸困难的发生率更高，而哮喘患者中头痛和热感的发生率更高(分别为40.3%vs.22.4%,6% vs.18.4% 和10.4% vs.26.5%；所有p<0.05)。尽管其他不良反应发生率无差异，我们发现哮喘患者中潮红、口干、出汗和疲乏的发生率更高（分别为1.5% vs. 6.1%, 14.9% vs. 24.5%, 0% vs. 4.1% 和37.3% vs. 49%）。不良反应为自限性，除了三例持续呼吸困难患者（67例COPD患者中发生2例，49例哮喘患者中发生1例）需要给予茶碱。两组患者的血压均无明显变化，但COPD患者使用Regadenoson（瑞加德松）后，收缩压增加趋势更明显(148.3±27.6 vs. 154.6±31.0 mmHg, p=0.056)。
结论：本研究显示在进行心肌灌注显像的COPD和哮喘患者中，具有良好的安全性。所有患者对Regadenoson（瑞加德松）耐受性良好，两组间呼吸困难、头痛和热感发生率有差别。
（苏楠 审校）
Eur J Nucl Med Mol Imaging. 2013 Jul 16. [Epub ahead of print]
Comparative study of the safety of regadenoson between patients with mild/moderate chronic obstructive pulmonary disease and asthma.
Garcia CS, Heffernan AJ, Sanchez de Mora E, Ramos Font C, Lopez Martin J, Rivera de Los Santos F, Ynfante Milá I.
Abstract
PURPOSE: To compare the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise, between subjects with mild/moderate chronic obstructive pulmonary disease (COPD) and asthma referred for myocardial perfusion imaging (MPI).
METHODS: We studied 116 patients, of whom 67 had COPD and 49 asthma (62% men, mean age 68.3 ± 11.3years, range 31-87years). Patient demographics, past medical history, medications, clinical symptoms during stress and changes in blood pressure (BP) and heart rate (HR) were evaluated.
RESULTS: Both groups were comparable with regard to hypertension, dyslipidaemia, diabetes and medications with the exception of a higher rate of use of anticholinergics in patients with COPD and of antileukotrienes in asthmatics (58.2% vs. 28.6% and 1.5% vs.14.3%, respectively; all p < 0.01). There was a higher incidence of dyspnoea in COPD patients and of headache and feeling hot in asthmatic patients (40.3% vs. 22.4%, 6% vs. 18.4% and 10.4% vs. 26.5%, respectively; all p < 0.05). Although there was no difference in the incidence of other adverse events, we observed a higher frequency in asthmatics of flushing, dry mouth, sweating and fatigue (1.5% vs. 6.1%, 14.9% vs. 24.5%, 0% vs. 4.1% and 37.3% vs. 49%, respectively). Adverse events were self-limiting, except in three patients who suffered persistent dyspnoea (2 of 67 COPD patients; 1 of 49 asthma patients) requiring theophylline administration. We observed no significant changes in BP among either group, but there was a tendency towards a higher increase in systolic BP in COPD patients followingregadenoson administration (148.3± 27.6vs.154.6± 31.0 mmHg, p = 0.056).
CONCLUSION: This study showed a good safety profile in our series of COPD and asthma patients undergoing MPI. Regadenoson was well tolerated by all patients, with dyspnoea, headache and feeling hot showing differences between groups.
Eur J Nucl Med Mol Imaging. 2013 Jul 16. [Epub ahead of print]
