Shlaes D M, Lederman M M, Chmielewski R, Tweardy D, Krause G, Saffai C
Chest. 1984 Jun;85(6):763-6. doi: 10.1378/chest.85.6.763.
Potassium hydroxide (KOH) preparations for elastin fibers on sputum obtained from 80 patients seen over a four-month period at two Cleveland hospitals were performed. The results were compared with roentgenographic evidence of necrosis and case diagnosis. Sixty-one patients had neither elastin in sputum nor roentgenographic evidence of cavitation; 11 had positive results using both methods. Two patients had no elastin fibers in sputum but had parenchymal pulmonary cavities on chest x-ray film. Six patients had elastin observed in KOH preparations of sputum, but no cavitation roentgenographically. The presence of elastin in sputum was strongly correlated with roentgenographic evidence of pulmonary necrosis (p = 5.7 X 10(-8]. Including patients seen before, after, and during the prospective study, we have observed a total of nine with positive sputum preparations for elastin and no cavitation on chest x-ray film for whom tissue was available for study. All had pulmonary necrosis histologically. Our observations suggest that the KOH preparation of sputum for elastin fibers may be more sensitive than the chest roentgenogram in the detection of pulmonary necrosis and may be a useful adjunct in the diagnosis of necrotizing disease.
对在克利夫兰两家医院为期四个月内就诊的80例患者的痰液进行了弹性纤维的氢氧化钾（KOH）制片检查。将结果与坏死的X线证据及病例诊断进行了比较。61例患者痰液中既无弹性纤维，X线也无空洞形成的证据；11例患者两种方法检查结果均为阳性。2例患者痰液中无弹性纤维，但胸部X线片显示有肺实质空洞。6例患者痰液的KOH制片中观察到弹性纤维，但X线检查无空洞形成。痰液中弹性纤维的存在与肺部坏死的X线证据密切相关（p = 5.7×10⁻⁸）。纳入前瞻性研究之前、之后及研究期间就诊的患者，我们共观察到9例痰液弹性纤维制片阳性且胸部X线片无空洞形成、有组织可供研究的患者。所有患者组织学检查均有肺坏死。我们的观察结果表明，痰液弹性纤维的KOH制片在检测肺部坏死方面可能比胸部X线片更敏感，可能是坏死性疾病诊断的有用辅助手段。
