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哮喘患者气管支气管的黏液纤毛清除功能:缓解期的损害

Tracheobronchial mucociliary clearance in asthma: impairment during remission.

作者信息

Pavia D, Bateman J R, Sheahan N F, Agnew J E, Clarke S W

出版信息

Thorax. 1985 Mar;40(3):171-5. doi: 10.1136/thx.40.3.171.

Abstract

Tracheobronchial mucociliary clearance was measured in eight non-smoking patients with asthma in complete remission. The patients were symptom free and required no medication whatsoever for one to six months before assessment. Mucociliary clearance was measured with an objective, radioaerosol technique. For comparison, mucociliary clearance of eight non-smoking, healthy subjects with physical characteristics and pulmonary function similar to those of the asthmatics was also measured on two occasions. In their first assessment the healthy subjects inhaled the tracer radioaerosol under experimental conditions similar to those used for the asthmatics; in the second assessment they inhaled the radioaerosol rapidly to simulate the asthmatic pattern of deposition. Under similar experimental conditions the radioaerosol was deposited more proximally in the asthmatic subjects than in the normal subjects and the difference was statistically significant (p less than 0.01). When, however, the depth of radioaerosol lung penetration was similar in the two groups, there was evidence of a significantly (p less than 0.01) poorer mucociliary clearance six hours after radioaerosol inhalation in the asthmatic than in the healthy group. These findings raise the question whether asthma ever remits completely.

摘要

对八名处于完全缓解期的非吸烟哮喘患者的气管支气管黏液纤毛清除功能进行了测量。这些患者无症状,在评估前一至六个月无需任何药物治疗。采用客观的放射性气溶胶技术测量黏液纤毛清除功能。为作比较,还对八名非吸烟健康受试者的黏液纤毛清除功能进行了两次测量,这些受试者的身体特征和肺功能与哮喘患者相似。在首次评估中,健康受试者在与哮喘患者相似的实验条件下吸入示踪放射性气溶胶;在第二次评估中,他们快速吸入放射性气溶胶以模拟哮喘患者的沉积模式。在相似的实验条件下,放射性气溶胶在哮喘患者体内的沉积部位比正常受试者更靠近近端,差异具有统计学意义(p小于0.01)。然而,当两组中放射性气溶胶在肺内的穿透深度相似时,有证据表明,哮喘患者在吸入放射性气溶胶六小时后的黏液纤毛清除功能明显(p小于0.01)比健康组差。这些发现提出了哮喘是否能完全缓解的问题。

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