Popov T A, Pizzichini M M, Pizzichini E, Kolendowicz R, Punthakee Z, Dolovich J, Hargreave F E
Dept of Medicine, St. Joseph's Hospital, Hamilton, Ontario, Canada.
Eur Respir J. 1995 Apr;8(4):559-65.
Inhalation of hypertonic saline aerosol is a relatively noninvasive method to obtain sputum for examination of inflammatory processes in the airways. We investigated some technical factors which might influence the success of induction and sputum cell counts. In total, twenty six asthmatic and 13 healthy subjects, unable to raise sputum spontaneously, inhaled nebulized saline for three 7 min intervals. In three randomized, cross-over studies we repeated sputum induction on separate days with two ultrasonic nebulizers (De Vilbiss Ultraneb 99 and Fisoneb) and one jet nebulizer (Pari LL with Master Compressor) (Study 1, n = 15), with different saline concentrations (normal saline 0.9%; hypertonic saline 3% on 2 days; and hypertonic saline 3, 4 and 5%, sequentially) (Study 2, n = 14) and with pretreatment with either salbutamol or placebo (Study 3, n = 10). The latter two studies were double-blind. Sputum cells were dispersed with dithiothreitol, and the cell suspension was used to perform total cell counts and to prepare cytospins for differential cell counts. We compared success rate, cell counts, subject discomfort and percentage fall in forced expiratory volume in one second (FEV1) during the procedures. All sputum examinations were performed blind to the clinical procedures. The success rates and the cell counts of the specimens obtained with the two ultrasonic nebulizers were not different, whilst general discomfort was proportional to the saline output of the nebulizer. Induction of sputum by hypertonic saline was more successful than normal saline, but more disagreeable to the subjects. Induction with saline 3% on two days was only successful in 6 of 14 subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
吸入高渗盐气雾剂是一种相对无创的获取痰液以检查气道炎症过程的方法。我们研究了一些可能影响诱导成功率和痰液细胞计数的技术因素。总共26名哮喘患者和13名无法自行咳出痰液的健康受试者，分三个7分钟时间段吸入雾化盐水。在三项随机交叉研究中，我们在不同日期使用两台超声雾化器（德维比斯Ultraneb 99和菲索尼雾化器）和一台喷射雾化器（帕里LL搭配主压缩机）重复进行痰液诱导（研究1，n = 15），使用不同浓度的盐水（0.9%生理盐水；两天使用3%高渗盐水；以及依次使用3%、4%和5%高渗盐水）（研究2，n = 14），并在使用沙丁胺醇或安慰剂进行预处理后进行（研究3，n = 10）。后两项研究为双盲研究。痰液细胞用二硫苏糖醇分散，细胞悬液用于进行总细胞计数并制备细胞涂片进行细胞分类计数。我们比较了诱导成功率、细胞计数、受试者不适程度以及操作过程中一秒用力呼气量（FEV1）的下降百分比。所有痰液检查均在对临床操作不知情的情况下进行。两台超声雾化器获取的标本的成功率和细胞计数没有差异，而总体不适程度与雾化器的盐水输出量成正比。高渗盐水诱导痰液比生理盐水更成功，但受试者感觉更不适。两天使用3%盐水诱导，14名受试者中只有6名成功。（摘要截断于250字）
