Nakamura S
Department of Pneumology, Metropolitan Hiroo General Hospital, Tokyo.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Nov;28(11):1421-5.
We analysed sputum properties based on certain clinical information such as sputum volume, its gross appearance, the diagnosis, and difficulty in expectoration. We also compared sputum properties, clinical information and the effects of inhalation drugs on sputum in vitro, and on this basis evaluated the indications and limitations of inhalation therapy. It appears that inhalation therapy is limited by sputum properties, because the properties of large amounts of sputum, purulent sputum, and sputum expectorated with great difficulty are apparently different from those of other types of sputum. The effect of inhalation drugs on sputum was studied in vitro. Distilled water and normal saline showed as mucolytic agents. Bromhexine was acids in solution. The acidity caused the sputum to gel and reduced its mucolytic effect. Tyloxapole was alkaline in solution. The alkalinity decreased the mucociliary transport rate (MTR). Acetylcysteine had a marked mucolytic effect and decreased the MTR. There was a particular desire to develop drugs which improved MTR, because MTR is impaired by large amounts of sputum and sputum expectorated with great difficulty as well as in the case of sputum from diffuse panbronchiolitis patients.
我们根据痰液量、大体外观、诊断及咳痰难度等特定临床信息分析痰液特性。我们还比较了痰液特性、临床信息以及吸入药物在体外对痰液的影响，并在此基础上评估吸入治疗的适应证和局限性。吸入治疗似乎受痰液特性限制，因为大量痰液、脓性痰液及咳痰困难的痰液特性与其他类型痰液明显不同。在体外研究了吸入药物对痰液的影响。蒸馏水和生理盐水表现为黏液溶解剂。氨溴索在溶液中呈酸性。酸性导致痰液凝胶化并降低其黏液溶解作用。泰洛沙泊在溶液中呈碱性。碱性降低黏液纤毛转运速率（MTR）。乙酰半胱氨酸有显著的黏液溶解作用并降低MTR。特别希望研发能改善MTR的药物，因为大量痰液、咳痰困难以及弥漫性泛细支气管炎患者的痰液均会损害MTR。
