Fazio F, Lafortuna C L
Respiration. 1986;50(1):62-5. doi: 10.1159/000194908.
Aerosolized steroids may be implicated in the increased incidence of chest infections. To evaluate such a possibility, we utilized a double-blind study to investigate the acute effect of inhaled beclomethasone dipropionate on mucociliary clearance in 10 patients with chronic obstructive lung disease (5 receiving the drug and 5 placebo). Mucociliary clearance was measured by inhalation of a 99mTc-labelled albumin aerosol. The resulting radioactivity was recorded externally by a large-field gamma camera and dedicated computer for 3 consecutive hours without patient repositioning. After 1-hour baseline recording, the subjects inhaled from a commercial pressurized canister either beclomethasone dipropionate (250 micrograms) or vehicle alone. The recording was then continued for 2 more hours. No statistically significant difference was found in clearance rates throughout the entire period of observation between patients receiving beclomethasone and controls. The data suggest that mechanisms other than mucociliary function impairment are responsible for the increased incidence of chest infections which may accompany steroid treatment by the inhalatory route.
雾化吸入类固醇可能与胸部感染发生率增加有关。为评估这种可能性，我们采用双盲研究，调查吸入丙酸倍氯米松对10例慢性阻塞性肺疾病患者（5例接受药物治疗，5例接受安慰剂治疗）黏液纤毛清除功能的急性影响。通过吸入99mTc标记的白蛋白气雾剂来测量黏液纤毛清除功能。使用大视野γ相机和专用计算机连续3小时在患者体位不变的情况下外部记录产生的放射性。在1小时基线记录后，受试者从市售加压罐中吸入丙酸倍氯米松（250微克）或仅吸入赋形剂。然后再继续记录2小时。在整个观察期间，接受倍氯米松治疗的患者与对照组之间的清除率没有统计学上的显著差异。数据表明，黏液纤毛功能受损以外的机制是吸入途径使用类固醇治疗时可能伴随的胸部感染发生率增加的原因。
