Ervine Evelyn, McMaster Cyril, McCallion William, Shields Michael D
Respiratory Research Group, Queen's University Belfast, Northern Ireland, UK.
J Pediatr Surg. 2009 Oct;44(10):1938-41. doi: 10.1016/j.jpedsurg.2009.03.020.
The purpose of this study was to investigate if pepsin measured in sputum is a useful marker of pulmonary aspiration secondary to gastroesophageal reflux (GER) in children. It is possible that the induced sputum procedure could cause GER and invalidate the results. The hypothesis stated that healthy children (those without history of respiratory or gastroesophageal symptoms) would not have pepsin detected in induced sputum.
Children attending surgical outpatients in the Royal Belfast Hospital for Sick Children (Belfast, Northern Ireland) were recruited. After spirometry, sputum was obtained by induction with hypertonic 3% saline. Spirometry was repeated, and complications were noted. An "in-house" enzyme-linked immunosorbent assay was used to measure pepsin concentration in sputum. The lower limit of detection of pepsin was 1.19 ng/mL.
Children (n = 21) aged 4 to 16 years were recruited. Twenty children completed the study. No adverse effects were reported. Pepsin was detected in 17 (85%) of 20 sputum samples.
The act of sputum induction appears to induce physiologic GER in a healthy childhood population. The analysis of pepsin in sputum obtained by sputum induction is therefore not useful in the investigation of reflux-related respiratory disease.
本研究旨在探讨痰液中检测到的胃蛋白酶是否是儿童胃食管反流（GER）继发肺误吸的有用标志物。诱导痰液的操作可能会导致GER并使结果无效。该假设指出，健康儿童（无呼吸或胃食管症状病史者）诱导痰液中不会检测到胃蛋白酶。
招募在皇家贝尔法斯特儿童医院（北爱尔兰贝尔法斯特）外科门诊就诊的儿童。肺活量测定后，用3%高渗盐水诱导获取痰液。重复进行肺活量测定，并记录并发症。采用“内部”酶联免疫吸附测定法测量痰液中胃蛋白酶浓度。胃蛋白酶的检测下限为1.19 ng/mL。
招募了4至16岁的儿童（n = 21）。20名儿童完成了研究。未报告不良反应。20份痰液样本中有17份（85%）检测到胃蛋白酶。
诱导痰液的行为似乎会在健康儿童群体中诱发生理性GER。因此，对诱导痰液获取的痰液中胃蛋白酶的分析在反流相关呼吸道疾病的研究中无用。
