Aitken Moira L, Greene Kelly E, Tonelli Mark R, Burns Jane L, Emerson Julia C, Goss Christopher H, Gibson Ronald L
Department of Medicine, Division of Pulmonary and Critical Care, University of Washington, Seattle 98195, USA.
Chest. 2003 Mar;123(3):792-9. doi: 10.1378/chest.123.3.792.
Sputum induction (SI) is a noninvasive tool for sampling inflamed airways. The purpose of this study was to determine the optimal duration of collection in patients with cystic fibrosis (CF). The hypothesis was that the duration of SI collection would quantitatively and qualitatively alter the content of the induced sputum.
In 10 clinically stable patients with CF (mean +/- SD age, 28 +/- 7 years; mean FEV(1), 2.6 +/- 0.7 L), SI was performed with 3% hypertonic saline solution at five time points over 20 min.
SI was well tolerated, with an average maximum fall in FEV(1) of 7 +/- 7%. The sample volumes, urea concentrations, interleukin-8 concentrations, total cell counts, and nonsquamous cell counts remained constant (p > 0.05). The percentage of neutrophils decreased from 89 +/- 5% to 86 +/- 4% (p = 0.03), and the percentage of alveolar macrophages increased 5 +/- 2% to 8 +/- 4% (p < 0.01). The mean quantitative microbiological counts of nonmucoid Pseudomonas aeruginosa and Staphylococcus aureus decreased over the 20-min time period each by half a log (p = 0.05 and p < 0.01, respectively). Surfactant protein-A concentration increased from 1.6 +/- 0.3 to 2.4 +/- 0.4 ng/mL (log(10); p < 0.001).
We conclude that aliquots of induced sputum are similar in clinically stable patients with CF during 4-min intervals, although there is more alveolar sampling after 20 min. When induced-sputum samples are fractionated for research monitoring of inflammatory or microbiologic indexes, power calculations accounting for these variations over time are required.
痰液诱导（SI）是一种用于采集炎症气道样本的非侵入性工具。本研究的目的是确定囊性纤维化（CF）患者的最佳采集持续时间。假设是痰液诱导采集的持续时间会在数量和质量上改变诱导痰液的成分。
对10例临床稳定的CF患者（平均年龄±标准差，28±7岁；平均第一秒用力呼气容积[FEV(1)]，2.6±0.7L），在20分钟内的五个时间点用3%高渗盐溶液进行痰液诱导。
痰液诱导耐受性良好，FEV(1)平均最大下降7±7%。样本体积、尿素浓度、白细胞介素-8浓度、总细胞计数和非鳞状细胞计数保持恒定（p>0.05）。中性粒细胞百分比从89±5%降至86±4%（p=0.03），肺泡巨噬细胞百分比从5±2%增至8±4%（p<0.01）。在20分钟时间段内，非黏液性铜绿假单胞菌和金黄色葡萄球菌的平均定量微生物计数各下降半对数（分别为p=0.05和p<0.01）。表面活性蛋白A浓度从1.6±0.3增至2.4±0.4ng/mL（以10为底的对数；p<0.001）。
我们得出结论，在4分钟间隔内，临床稳定的CF患者诱导痰液的等分样本相似，尽管20分钟后肺泡采样更多。当对诱导痰液样本进行分馏以研究炎症或微生物指标监测时，需要考虑这些随时间变化的功效计算。
