Mortensen J, Jensen C, Groth S, Lange P
Department of Clinical Physiology, Rigshospitalet, Copenhagen, Denmark.
Clin Physiol. 1991 Sep;11(5):439-50. doi: 10.1111/j.1475-097x.1991.tb00816.x.
Animal studies have shown that frequent coughing may damage the mucociliary apparatus in flow-limiting segments of the central airways. To determine whether mucociliary clearance in humans is affected by repeated dynamic compression associated with forced expirations, we measured pulmonary deposition and mucociliary clearance for 2 h of inhaled [99Tcm]albumin. The subjects inhaled [99Tcm]albumin on 2 study days (randomized) using (A) slow inspirations and forced expirations, while inhalation using (B) forced inspirations and slow expirations served as control. The study was conducted using 10 patients with chronic hypersecretory/obstructive bronchitis and six normal subjects. We found that inhalation of [99Tcm]albumin by the two manoeuvres (A and B) resulted in similar patterns of aerosol deposition. There was no significant difference in retention of radioactivity in the central lung region at 1 h in the patients with chronic bronchitis after inhalation with manoeuvre A (102%) and with manoeuvre B (91.5%), or in the healthy subjects after manoeuvre A (74%) and manoeuvre B (77%). There was also no difference in the retention at 2 h or in overall mucociliary clearance in any of the groups. We conclude that dynamic compression in the central airways associated with forced expiration does not affect bronchial clearance in the airways of healthy subjects or in patients with chronic bronchitis.
动物研究表明，频繁咳嗽可能会损害中央气道限流段的黏液纤毛装置。为了确定人类的黏液纤毛清除功能是否受到与用力呼气相关的反复动态压缩的影响，我们测量了吸入[99锝]白蛋白2小时后的肺部沉积和黏液纤毛清除情况。在2个研究日（随机分组），受试者吸入[99锝]白蛋白，其中（A）组采用缓慢吸气和用力呼气，而（B）组采用用力吸气和缓慢呼气作为对照。该研究纳入了10例慢性分泌过多/阻塞性支气管炎患者和6名正常受试者。我们发现，通过两种操作（A和B）吸入[99锝]白蛋白后，气溶胶沉积模式相似。在慢性支气管炎患者中，操作A吸入后1小时中央肺区放射性滞留率为102%，操作B吸入后为91.5%；在健康受试者中，操作A吸入后为74%，操作B吸入后为77%，两者在中央肺区放射性滞留率上无显著差异。在任何一组中，2小时时的滞留情况或总体黏液纤毛清除情况也没有差异。我们得出结论，与用力呼气相关的中央气道动态压缩不会影响健康受试者或慢性支气管炎患者气道中的支气管清除功能。
