Lauque D, Aug F, Puchelle E, Karcher G, Tournier J M, Bertrand A, Polu J M, Sadoul P
Bull Eur Physiopathol Respir. 1984 Mar-Apr;20(2):145-9.
Progressive alterations in the in vitro transport properties of airway secretions according to the severity and duration of bronchitis have been previously reported, but the potential in vivo dysfunction of bronchial clearance during different phases of bronchitis has not yet been studied. We measured bronchial mucociliary clearance (CMC) and clearance by cough (CTx) using a radioactive aerosol technique (resin particles 7.4 micron in diameter, tagged with technetium-99 m) in patients with recurrent bronchitis (group I, n = 5) and in chronic bronchitic patients, either at an early (group II, n = 13) or advanced (group III, n = 17) stage of their disease. The results were compared with those obtained from a control group (group 0, n = 10) and the respective efficiencies of the mucociliary system and cough were analysed with reference to respiratory function. The initial deposition of the aerosol in central airways is similar in all the patients and healthy subjects. In comparison with group 0, the mucociliary clearance is only significantly reduced in groups II and III (p less than 0.02). In healthy subjects, the clearance by cough is very weak, whereas in bronchitic patients it can be roughly equal to or greater than the CMC. However, the cough is less efficient in group III than in group II (p less than 0.05). A reduced efficiency of the clearance by cough occurs together with abnormalities in the gas exchange.
先前已有报道称，根据支气管炎的严重程度和病程，气道分泌物的体外转运特性会发生渐进性改变，但尚未对支气管炎不同阶段支气管清除功能在体内的潜在功能障碍进行研究。我们使用放射性气溶胶技术（直径7.4微米、标记有锝-99m的树脂颗粒），对复发性支气管炎患者（第一组，n = 5）以及处于疾病早期（第二组，n = 13）或晚期（第三组，n = 17）的慢性支气管炎患者，测量其支气管黏液纤毛清除率（CMC）和咳嗽清除率（CTx）。将结果与对照组（第0组，n = 10）的结果进行比较，并参照呼吸功能分析黏液纤毛系统和咳嗽各自的效率。所有患者和健康受试者中，气溶胶在中央气道的初始沉积情况相似。与第0组相比，仅第二组和第三组的黏液纤毛清除率显著降低（p < 0.02）。在健康受试者中，咳嗽清除率非常低，而在支气管炎患者中，咳嗽清除率大致可等于或大于黏液纤毛清除率。然而，第三组的咳嗽清除效率低于第二组（p < 0.05）。咳嗽清除效率降低与气体交换异常同时出现。
