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[摘要] 目的 评价肌注盐酸戊乙奎醚（长托宁）在慢性阻塞性肺疾病急性加重期（AECOPD）患者中的疗效和安全性。 方法 对43例慢性阻塞性肺疾病急性加重期患者随机分为二组，治疗组23例，对照组20例，治疗组肌注长托宁。二组分别测定用药前及用药后不同时间最大呼气流速（PEF）、第一秒用力呼气量(FEV1),同时观察用药前后症状和体征及动脉血气的变化，并观察其副作用。结果 ①用药后FEV1和PEF改善，FEV1平均增加295ml(P<0.000),PEF改善最高达37L/min(P<0.000)。②呼吸频率用药30分钟后明显减慢（P<0.01），与对照组比较在第三天最为明显。心率减慢(P<0.01)出现在第二天后。③咳嗽、咳痰量、气促、肺部罗音在用药后出现改善，第三天评分值最低（P<0.01）。④血气在用药后明显改善，PaO2上升12 mmHg(P<0.000)；PaCO2平均下降7 mmHg(P<0.001)。⑤副作用大部分患者有口干，有二例出现轻度“阿托品”化症状。 结论 长托宁能改善中、重度慢性阻塞性肺病急性加重期患者的症状和体征，并改善患者的肺功能。预示它是一种非常有前途的长效抗胆碱能药物。
【Abstract】Objective：To evaluate the efficiency and safety of intramuscular injection penehyclidine hydyochloride (PHC) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods：43 patients were devided into 2 groups at random , 治疗组２３例，对照组２０例．治疗组were injected PHC. Peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1).was measured at different time before and after drug-givin. Symptoms and signs , blood gas analysis and side-effects were also observed. Results： ①FEV1 and PEF were improved after drug-givin, the average improving of FEV1 was 294ml (P<0.000). PEF was improved greatly two days after drug-givin with a maximum increase of 42L/min (P<0.000). ② RF respiratory decreased apparently after drug-givin（P<0.01）and HRheat decreased one day after drug-givin(P<0.05). ③The scores of cough ,sputum，dyspnea and pulmonary rale were improved after drug-givin and came up to the best two days after drug-givin（P<0.01）.④blood gas analysis was improved after drug-givin, PaO2 increased by 12 mmHg(P<0.000),and PaCO2 decreased averagely by 7 mmHg(P<0.001) ⑤Side-effect of PHC occurred in most patients was thirst. The low-grade symptom of “atropinization” occurred in two cases. Conclusions：PHC can improve the symptoms and signs of patients in mild and severe AECOPD as well as the lung function. This suggests that PHC is a promising long-acting anticholinergic bronchodilator.