Laube Beth L, Karmazyn Yauel J, Orens Jonathan B, Mogayzel Peter J
Eudowood Division of Pediatric Respiratory Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-2533, USA.
J Heart Lung Transplant. 2007 Feb;26(2):138-44. doi: 10.1016/j.healun.2006.11.005.
Previous studies have shown that mucociliary clearance (MCC) is diminished after lung transplantation. However, it is unknown how early this deficit occurs after transplantation, or whether the abnormality can be improved by pharmacologic means. We hypothesized that impairment of MCC is evident soon after lung transplantation and that the defect in MCC can be improved by inhaled beta(2)-adrenergic receptor agonists.
MCC and cough clearance (CC) were quantified in seven patients at 76 +/- 48 days (mean +/- standard deviation) after lung transplantation (baseline visit) and again 1 week later after an acute inhalation of albuterol. MCC was also determined once in four healthy subjects. To measure MCC, volunteers inhaled 99m-technetium-sulfur colloid aerosol, followed by gamma-camera imaging of their lungs for 76 minutes.
Baseline MCC was significantly reduced in transplant patients, compared with healthy subjects, averaging 8.9 +/- 7.3% and 20.9 +/- 15.1%, respectively (p = 0.05). CC was not affected by transplantation. Acute inhalation of albuterol significantly improved MCC in transplant patients (31.9 +/- 21.9%) compared with baseline values (p < 0.05).
MCC is diminished within a few months after transplantation. However, the response to albuterol suggests that the deficit is not static and can be improved with inhalation of a beta(2)-adrenergic receptor agonist.
既往研究表明，肺移植后黏液纤毛清除功能（MCC）会减弱。然而，移植后这种功能缺陷多早出现，以及该异常能否通过药物手段改善尚不清楚。我们推测，肺移植后不久MCC功能损害即很明显，且吸入β2肾上腺素能受体激动剂可改善MCC缺陷。
对7例肺移植患者在移植后76±48天（均值±标准差）（基线访视）时的MCC和咳嗽清除功能（CC）进行量化，并在急性吸入沙丁胺醇1周后再次测量。还对4名健康受试者进行了一次MCC测定。为测量MCC，志愿者吸入99m锝-硫胶体气雾剂，随后用γ相机对其肺部进行76分钟成像。
与健康受试者相比，移植患者的基线MCC显著降低，分别平均为8.9±7.3%和20.9±15.1%（p = 0.05）。CC不受移植影响。与基线值相比，移植患者急性吸入沙丁胺醇后MCC显著改善（31.9±21.9%）（p < 0.05）。
移植后数月内MCC功能减弱。然而，对沙丁胺醇的反应表明该缺陷并非一成不变，吸入β2肾上腺素能受体激动剂可改善此缺陷。
