使用吸入性乙酰甲胆碱或高渗盐水诱导痰液的比较。

Comparison of sputum induction using inhaled methacholine or hypertonic saline.

作者信息

James Alan L, Maxwell Peta S, Elliot John G

机构信息

West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

出版信息

Respirology. 2005 Jan;10(1):57-62. doi: 10.1111/j.1440-1843.2005.00632.x.

DOI:10.1111/j.1440-1843.2005.00632.x

PMID:15691239

Abstract

OBJECTIVES

Hypertonic saline is recommended for the induction of sputum to assess airway inflammation. Methacholine is most commonly used to assess airway responsiveness. The aim of this study was to compare sputum induction by methacholine and hypertonic saline challenges, and the subsequent inflammatory cell differential counts.

METHODOLOGY

Subjects (n = 56) underwent inhaled hypertonic saline (4.5% for < or = 15 min without bronchodilator pretreatment) and methacholine (maximum cumulative dose 4 micromol) challenges 1 week apart, in random order. Sputum was processed, and on cytospins stained with May-Grunwald-Giemsa, a total of 400 inflammatory plus squamous cells were counted to obtain a differential cell count.

RESULTS

A satisfactory sputum sample was obtained from 29 subjects following hypertonic saline and also from 10 subjects following methacholine. For these 10 subjects, the mean percent macrophages, neutrophils, eosinophils, and lymphocytes were similar after methacholine (64%, 26%, 7% and 1%) or hypertonic saline (67%, 26%, 6% and 1%). The results were similar for squamous cells (42% and 45%) and when asthmatics and nonasthmatics were compared separately.

CONCLUSIONS

Inhaled methacholine has a much lower yield of sputum induction compared with hypertonic saline. However, the differential sputum cell count is similar following both challenge agents.

摘要

目的

推荐使用高渗盐水诱导痰液以评估气道炎症。乙酰甲胆碱是最常用于评估气道反应性的药物。本研究的目的是比较乙酰甲胆碱和高渗盐水激发试验诱导痰液的情况，以及随后的炎症细胞分类计数。

方法

56名受试者随机顺序接受吸入高渗盐水（4.5%，持续≤15分钟，无支气管扩张剂预处理）和乙酰甲胆碱（最大累积剂量4微摩尔）激发试验，间隔1周。对痰液进行处理，在经May-Grunwald-Giemsa染色的细胞涂片上，计数总共400个炎症细胞加鳞状细胞以获得细胞分类计数。

结果

29名受试者在高渗盐水激发试验后获得了满意的痰液样本，10名受试者在乙酰甲胆碱激发试验后获得了满意的痰液样本。对于这10名受试者，乙酰甲胆碱激发试验后（巨噬细胞、中性粒细胞、嗜酸性粒细胞和淋巴细胞的平均百分比分别为64%、26%、7%和1%）和高渗盐水激发试验后（分别为67%、26%、6%和1%）的情况相似。鳞状细胞的结果相似（分别为42%和45%），且分别比较哮喘患者和非哮喘患者时结果也相似。