Stockley R A, Hill S L, Morrison H M, Starkie C M
Thorax. 1984 Jun;39(6):408-13. doi: 10.1136/thx.39.6.408.
Sputum samples from 34 patients with bronchiectasis were assessed subjectively and the results related to objective measurements of elastase activity and albumin content. The results suggest that the macroscopic appearance of the sample is related to the elastase content. 88.7% of the purulent samples but none of the mucoid samples showing elastase activity. The macroscopic appearance was also associated with changes in protein transudation into the secretions. The median sputum: serum albumin concentration ratio was 0.71 X 10(-2) (range 0.22-4.7) in the mucoid samples but was greater in purulent samples (p less than 0.005), with a median value of 1.52 X 10(-2) (range 0.55-12.72), suggesting that purulence in the stable state was associated with low grade pulmonary inflammation or epithelial damage or both. Abnormalities of air flow were found in 24 of the patients (70.6%) but there was a significantly higher ratio of residual volume to total lung capacity (p less than 0.025) in patients who regularly produced purulent sputum (mean (SD) RV/TLC 44.4% (9.0%] than in those with mucoid or mucopurulent secretions (38.0% (9.9%]. A similar difference was found between those who produced elastase positive secretions and those who produced elastase negative ones.
对34例支气管扩张患者的痰液样本进行了主观评估，并将结果与弹性蛋白酶活性和白蛋白含量的客观测量结果相关联。结果表明，样本的宏观外观与弹性蛋白酶含量有关。88.7%的脓性样本显示有弹性蛋白酶活性，而黏液样样本均未显示。宏观外观还与分泌物中蛋白质渗出的变化有关。黏液样样本中痰液与血清白蛋白浓度的中位数比值为0.71×10⁻²（范围0.22 - 4.7），但脓性样本中的该比值更高（p<0.005），中位数为1.52×10⁻²（范围0.55 - 12.72），这表明稳定状态下的脓性与低度肺部炎症或上皮损伤或两者都有关。24例患者（70.6%）存在气流异常，但定期咳出脓性痰液的患者残气量与肺总量的比值显著更高（p<0.025）（平均（标准差）RV/TLC 44.4%（9.0%）），高于咳出黏液样或黏液脓性分泌物的患者（38.0%（9.9%））。在产生弹性蛋白酶阳性分泌物的患者和产生弹性蛋白酶阴性分泌物的患者之间也发现了类似差异。
