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目的探讨严重慢性阻塞性肺疾病（ＣＯＰＤ）患者每日１次和２次口服茶碱的血清浓度变化及对２４小时肺功能和睡眠的影响。方法１０例严重ＣＯＰＤ患者，在治疗前先检测２４小时肺功能、多导睡眠图及对症状和睡眠质量进行量化评估，然后用双盲交叉设计的方法，随机先后进行茶碱每日２次和１次用法的研究，测定血清茶碱浓度并重复治疗前的研究内容。结果茶碱２０∶００服后在次日４∶００达峰值，８∶００服后在１２∶００达峰值，谷值均在２０∶００。在４∶００的茶碱浓度每日１次高于２次者，在１６∶００则相反（Ｐ＜０．０５）。茶碱两种方法的治疗对肺功能有相似但明显的改善（Ｐ＝０．０００１）。每日１次用法改善症状明显（Ｐ＝０．００２３）。两种方法对睡眠结构和质量无明显影响。结论口服茶碱缓释片在清晨有较高的血清浓度，较低的血茶碱水平（５～１０ｍｇ／Ｌ）对肺功能就有改善作用。上述茶碱服用方法及剂量对睡眠无明显影响。
Objective To investigate the changes of serum concentrations of oral theophylline once and twice daily in patients with severe chronic obstructive pulmonary disease (COPD) and their effects on lung function and sleep at 24 hours. Methods Ten patients with severe COPD were tested for 24-hour pulmonary function, polysomnography, and quantitative assessment of symptoms and sleep quality before treatment. Then, they were randomly assigned to two cycles of theophylline A study of usage, serum concentration of theophylline and repeat the study before treatment. Results Theophylline peaked at 4:00 the next day after serving at 20:00 and peaked at 12:00 at 8:00, with the troughs at 20:00. Theophylline concentration at 4:00 was higher than twice daily at 16:00 and vice versa (P <0.05). Theophylline treatment of both methods had similar but significant improvements in lung function (P = 0.0001). Once-daily use to improve symptoms significantly (P = 0.0023). Both methods have no significant effect on sleep structure and quality. Conclusion Oral hypophyseal sustained-release tablets have higher serum concentration in the early morning, and lower hypophylline level (5 ~ 10mg / L) can improve pulmonary function. The above method and dose of theophylline have no significant effect on sleep.