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[使用模拟气雾剂的诊断肺科]

[Diagnostic pneumology using model aerosols].

作者信息

Scheuch G, Kohlhäufl M, Sommerer K, Lichte H, Hess W, Schulz H, Häussinger K, Heyder J

机构信息

Klinische Kooperationsgruppe Aerosolmedizin des GSF Forschungszentrums für Umwelt und Gesundheit, München-Gauting.

出版信息

Pneumologie. 1999 Jul;53(7):329-36.

Abstract

Clearance of Aerosol Particles from the Airways: Measurement of the efficiency and kinetics of particle clearance from the airways is dependent on the site of particle deposition within the lungs. Insoluble particles deposited in the alveolar region are mainly cleared by macrophages over a period of hundreds of days, whereas particles from the tracheobronchial airways are mainly cleared within hours or days by mucociliary clearance. We introduce a method for mucociliary clearance measurements called 'Radio-Bolus-Scintigraphy'. A small volume of radiolabelled aerosol particles sandwiched in clean air (aerosol bolus) is inhaled near the end of a tidal breath which leads to a preferential deposition of the particles in the airways. Particles were Fe3O4 labelled with 99mTc with an aerodynamic particle diameter of 3.5 microns (monodisperse). The retention of the particles within the lungs was detected by Gamma Camera and Human Scintillation Counter. 26 healthy subjects volunteered in this study (14 nonsmokers and 12 smokers). The half width of the mucociliary clearance was found to be 2.4 h in nonsmokers and 3.3 h in smokers (p < 0.05). Intersubject variability was small, 24 hours after inhalation 55% (+/- 6%) of the inhaled particles were still found in the airways of the subjects. No difference was found between nonsmokers and smokers. Good intersubject reproducibility makes this method useful in therapy control as well as in early diagnosis of changes in mucociliary clearance kinetics and efficiency.

摘要

气道中气溶胶颗粒的清除

测量气道中颗粒清除的效率和动力学取决于颗粒在肺内的沉积部位。沉积在肺泡区域的不溶性颗粒主要在数百天内由巨噬细胞清除,而来自气管支气管气道的颗粒主要在数小时或数天内通过黏液纤毛清除。我们介绍一种用于黏液纤毛清除测量的方法,称为“放射性团注闪烁显像法”。在潮气末附近吸入一小体积夹在清洁空气中的放射性标记气溶胶颗粒(气溶胶团注),这会导致颗粒优先沉积在气道中。颗粒为用99mTc标记的Fe3O4,空气动力学粒径为3.5微米(单分散)。通过γ相机和人体闪烁计数器检测颗粒在肺内的滞留情况。26名健康受试者自愿参与本研究(14名非吸烟者和12名吸烟者)。发现非吸烟者黏液纤毛清除的半值宽度为2.4小时,吸烟者为3.3小时(p<0.05)。个体间变异性较小,吸入后24小时,仍有55%(±6%)的吸入颗粒在受试者气道中被发现。非吸烟者和吸烟者之间未发现差异。良好的个体间可重复性使得该方法在治疗控制以及黏液纤毛清除动力学和效率变化的早期诊断中有用。

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