- 期刊
硫酸鎂注射在於治療慢性阻塞性肺病併急性發作的功效
Intravenous Magnesium Sulfate for the Treatment of Chronic Obstructive Pulmonary Disease
摘要
硫酸鎂已被證實在治療嚴重氣喘病病人的急性發作上，是有效且安全的；而目前我們也知道合並使用ipratropium bromide和beta2-agonist吸蒸氣治療COPD比單獨使用beta2-agonist吸蒸氣治療更有療效，但如再合併硫酸鎂注射，尚未有任何研究報告。所以才提出此研究，以更進一步瞭解是否用更大劑量的硫酸鎂(2.0gm)且併用ipratropium bromide和beta2-agonlst吸蒸氣治療的實驗組，比單獨使用ipratropium bromide和beta2-agonist吸蒸氣治療的對照組有效。其研究結果顯示，利用ANOVA (analysis of variance)變方分析。當變方分析表中處理項F值未達5%差異顯著水凖時，不必進行任何處理間差異比較測驗，若其F值達到顯著水凖時，再應用 Tukcy's b test進行處理問差異比較測驗，以分析是否有明顯的差異性。結果證實驗組相較對照組在治療開始後40分鐘，50分鐘和治療開始後70分鐘，在PEF上才有統計學上有意義的差異性。而兩組的血壓、心跳和呼吸速率，在這幾項上，統計學並沒有明顯的差異性；而在病人主觀感覺症狀上，雖然實驗組比對照組的改善程度較高，但利用Wilcoxon signed rank test（魏爾森訊號等級測驗）分析，結果仍未達到統計上明顯的差異性；在副作用方面，除了3位元病人有注射部位局部燒熱感，1個病人抱怨有些從頭痛外，其他沒有什麼特別冉法忍受的症狀或危險的徵兆。由於本研完之人數尚嫌太少，且全部為男性，所以應該要有更多的樣本數及女性來做研究才會更有意義。
關鍵字
無資料並列摘要
A number of previous reports have suggested that magnesium sulfate(1.2 gm) infusion over 20 minutes after beta2-agonist administration, is safe and modestly efficacious in the treatment of chronic obstructive pulmonary disease (COPD) with acute exacerbations. The effectiveness of intravenous infusion of higher doses of magnesium sulfate(2. 0gm) was evaluated in an unblinded, randomized, placebo-controlled study. Thirty patients were assigned to one of two treatment regimens:(1) 2.0 gm MgSO4 in 50c.c. of saline intravenously 20 minutes in combination with a nebulizer treatment of 2 c.c. of 0.025% ipratropium bromide,0.5 c.c. (2.5mg)fenoterol and 2 c.c. 0.45% saline.(2) a 50 c.c. saline placebo intravenously 20 minutes in combination with a nebulizer treatment of 2 c.c. of 0.025% ipratropium bromide,0.5 c.c. (2.5mg) fenoterol and 2 c.c. 0.45% saline. Peak expiratory flow, blood pressure, respiratory rate and heart rate were monitored for 70 minutes after the start of MgSO4 or Placebo treatment. The PEFR increased from 119.67±45.51 L/min (mean ±SD) at he start of the infusion to,148.67±52.10 L/min at 20 minutes,149.67±52.65 L/min at 30 minutes, 150.33±54.48Lfmin at 40 minutes, 150.67 in±54.71L/min at 5 minutes, and 150.33±54.39 L/min at 70 minutes in the placebo group. The PEFR was 112.67±45.82 L/min on nitiation of the intravenous infusion, 167.33±52.62 L/min at 20 minutes, 183.33± 55.85 L/min at 30 minutes, 184.67±55.36 L/min at 40 minutes, 185.00±55.53 L/min at 50 minutes, and 184.00± 53.73 L/min at 70 minutes with magnesium sulfate and nebulizer treatment. Both groups demonstrated an increase in PEFR 20 mutes after the initial PEFR. The results showed that magnesium sulfate intravenous infusion in combination with beta2 -agonist and anticholinergic agent inhalation was more effective than placebo intravenous infusion in combination with beta2-agonist and anticholinergic agent inhalation by ANOVA test. Side effects noted among the magnesium group included local burning at the infusion site in three patients and mild headache in one. All side effects were well tolerated and were limited to the infusion period.