Tsang K W, Chan K, Ho P, Zheng L, Ooi G C, Ho J C, Lam W
University Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.
Chest. 2000 Feb;117(2):420-6. doi: 10.1378/chest.117.2.420.
To study the correlations between sputum elastase output with clinical and sputum inflammatory and microbial factors in steady-state bronchiectasis.
Prospective recruitment of patients with bronchiectasis (17 women; 48.5 +/- 16.5 years old; FEV(1)/FVC, 1.3 +/- 0.6/2.1 +/- 0.9) for assessment of 24-h sputum output of elastase, bacteria, leukocytes, interleukin (IL)-1beta, IL-8, tumor necrosis factor-alpha, and leukotriene B(4). Clinical variables assessed concomitantly included 24-h sputum volume, lung spirometry, number of lung lobes affected by bronchiectasis, and exacerbation frequency.
Consecutive recruitment of outpatients (n = 30) in steady-state bronchiectasis.
Twenty-four-hour sputum elastase output correlated with 24-h sputum volume (r = 0.79, p = 0.0001); number of bronchiectatic lung lobes (r = 0.54, p = 0.0026); percent predicted FEV(1) (r = -0. 48, p = 0.0068); percent predicted FVC (r = -0.49, p = 0.001); and leukocyte output (r = 0.75, p = 0.0001). There was no correlation between the sputum output of bacteria with either inflammatory or enzymatic factors (p > 0.05).
Our data highlight the importance of elastase and the possibility of independent roles for enzymatic, inflammatory, and microbial components in the pathogenesis of bronchiectasis. Further research on novel therapy targeting each of these components should be pursued.
研究稳定期支气管扩张症患者痰液弹性蛋白酶分泌量与临床、痰液炎症及微生物因素之间的相关性。
前瞻性招募支气管扩张症患者（17名女性；年龄48.5±16.5岁；FEV(1)/FVC为1.3±0.6/2.1±0.9），评估其24小时痰液中弹性蛋白酶、细菌、白细胞、白细胞介素（IL）-1β、IL-8、肿瘤坏死因子-α和白三烯B(4)的分泌量。同时评估的临床变量包括24小时痰液量、肺功能测定、支气管扩张累及的肺叶数量及病情加重频率。
连续招募稳定期支气管扩张症门诊患者（n = 30）。
24小时痰液弹性蛋白酶分泌量与24小时痰液量（r = 0.79，p = 0.0001）、支气管扩张累及的肺叶数量（r = 0.54，p = 0.0026）、预测FEV(1)百分比（r = -0.48，p = 0.0068）、预测FVC百分比（r = -0.49，p = 0.001）及白细胞分泌量（r = 0.75，p = 0.0001）相关。细菌痰液分泌量与炎症或酶学因素之间无相关性（p > 0.05）。
我们的数据突出了弹性蛋白酶的重要性，以及酶、炎症和微生物成分在支气管扩张症发病机制中发挥独立作用的可能性。应针对这些成分开展新型治疗的进一步研究。
