Suri Ranjan, Marshall Lindsay J, Wallis Colin, Metcalfe Christopher, Shute Janis K, Bush Andrew
Department of Respiratory Paediatrics, Royal Brompton Hospital, London, UK.
Pediatr Pulmonol. 2003 Apr;35(4):309-13. doi: 10.1002/ppul.10226.
We assessed the safety and use of induced sputum (IS) in children with cystic fibrosis (CF). Forty-eight children (19 males) with CF, mean age 12.6 (range, 7.3-17.0) years and median forced expired volume in 1 sec (FEV(1)) 48% (range, 14-77%) predicted were recruited. Patients spontaneously expectorated sputum and then performed sputum induction by inhalation of nebulized 7% hypertonic saline. Samples were sent for bacteriological culture, and for measurement of the following inflammatory mediators: interleukin-8, myeloperoxidase, eosinophil cationic protein, and neutrophil elastase activity. FEV(1) was performed before and after inhalation of hypertonic saline. There was no increase in mediator levels in IS compared to expectorated sputum (ES) samples. Only 3 patients demonstrated significant bronchoconstriction following inhalation of hypertonic saline, by the method used. From the ES samples, Pseudomonas aeruginosa was isolated in 13 patients, Staphylococcus aureus in 7 patients, Stenotrophomonas maltophilia in 1 patient, and both Pseudomonas aeruginosa and Staphylococcus aureus in 5 patients. All these organisms were found in the IS samples. However, in 2 patients whose ES grew no organisms, one patient's IS grew Pseudomonas aeruginosa, and the other patient's IS grew Staphylococcus aureus. In our study, sputum induction was safe, with no proinflammatory effect.
我们评估了诱导痰（IS）在囊性纤维化（CF）患儿中的安全性及应用情况。招募了48例CF患儿（19例男性），平均年龄12.6岁（范围7.3 - 17.0岁），1秒用力呼气容积（FEV₁）中位数为预计值的48%（范围14% - 77%）。患者先自行咳出痰液，然后通过吸入雾化的7%高渗盐水进行痰液诱导。样本被送去进行细菌学培养，并检测以下炎症介质：白细胞介素 - 8、髓过氧化物酶、嗜酸性粒细胞阳离子蛋白和中性粒细胞弹性蛋白酶活性。在吸入高渗盐水前后测量FEV₁。与咳出的痰液（ES）样本相比，IS中的介质水平没有升高。采用该方法，只有3例患者在吸入高渗盐水后出现明显支气管收缩。从ES样本中，13例患者分离出铜绿假单胞菌，7例患者分离出金黄色葡萄球菌，1例患者分离出嗜麦芽窄食单胞菌，5例患者同时分离出铜绿假单胞菌和金黄色葡萄球菌。所有这些微生物都在IS样本中被发现。然而，在2例ES未培养出微生物的患者中，1例患者的IS培养出铜绿假单胞菌，另1例患者的IS培养出金黄色葡萄球菌。在我们的研究中，痰液诱导是安全的，没有促炎作用。
