Bye Peter T P, Elkins Mark R
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown 2050, Australia.
Paediatr Respir Rev. 2007 Mar;8(1):30-9. doi: 10.1016/j.prrv.2007.02.008. Epub 2007 Mar 26.
This review examines specific mucoactive agents from three classes: expectorants, which add water to the airway; ion-transport modifiers, which promote ion and water transport across the epithelium of the airway; and mucokinetics, which improve cough-mediated clearance by increasing airflow or reducing sputum adhesivity. The agents are isotonic and hypertonic saline, mannitol, denufosol and beta-agonists. Our understanding of these agents has recently improved through pre-clinical research, clinical trials and, in particular, extensive research into the nature of the liquid lining the surface of the airway, both in health and in cystic fibrosis (CF). For each agent, recent research is reviewed, highlighting the evidence for possible mechanisms of action and for clinical efficacy in CF, as well as the implications for the optimal clinical application of the agent.
祛痰剂，可增加气道内的水分；离子转运调节剂，可促进离子和水分跨气道上皮转运；以及黏液动力学药物，可通过增加气流或降低痰液黏附性来改善咳嗽介导的清除作用。这些药物包括等渗和高渗盐水、甘露醇、地努福索和β受体激动剂。最近，通过临床前研究、临床试验，尤其是对健康和囊性纤维化（CF）患者气道表面液体衬里性质的广泛研究，我们对这些药物的认识有所提高。对每种药物，本文回顾了近期的研究，突出了其可能的作用机制和在CF中的临床疗效证据，以及该药物最佳临床应用的相关影响。
