Svartengren K, Philipson K, Svartengren M, Nerbrink O, Camner P
Department of Respiratory and Allergic Diseases, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Exp Lung Res. 1995 Sep-Oct;21(5):667-82. doi: 10.3109/01902149509050835.
In subjects with an inherited lack of mucociliary transport, so called immotile-cilia syndrome (ICS), coughing effectively clears particles deposited in larger airways of the tracheobronchial region. The present study investigated clearance in smaller airways of 111In-labeled 6-microm (aerodynamic diameter) monodisperse Teflon particles in six subjects with ICS. The particles were inhaled at an extremely slow flow, 0.05 L/s. Theoretical calculations and experimental data in healthy subjects using this slow flow support particle deposition mainly in smaller ciliated airways, i.e., in bronchioli (generations 12-16). This contrasts with the more centrally deposited pattern obtained using a normal inhalation flow, 0.5 L/s. Lung retention was measured at 0, 24, 48,72 and 96 h. Clearance was significant every 24 h measured over the first 72 h, whereupon it slowed down. The fractions of retained particles were significantly (p < .01) larger than those found for healthy subjects using the slow inhalation flow and those found for ICS subjects using a normal inhalation flow. The results indicate that clearance of particles in smaller airways is incomplete and that cough cannot fully compensate for the lack of mucociliary transport in this region.
在患有遗传性黏液纤毛运输缺乏症（即所谓的不动纤毛综合征，ICS）的受试者中，咳嗽可有效清除沉积在气管支气管区域较大气道中的颗粒。本研究调查了6名ICS受试者对111In标记的6微米（空气动力学直径）单分散聚四氟乙烯颗粒在较小气道中的清除情况。颗粒以极慢的流速0.05 L/s吸入。使用这种慢流速对健康受试者进行的理论计算和实验数据表明，颗粒主要沉积在较小的有纤毛气道，即细支气管（第12 - 16级）。这与使用正常吸入流速0.5 L/s时获得的更集中的沉积模式形成对比。在0、24、48、72和96小时测量肺部滞留情况。在最初的72小时内，每24小时测量一次清除情况，结果显示清除显著，此后清除速度减慢。滞留颗粒的比例显著高于（p <.01）使用慢吸入流速的健康受试者以及使用正常吸入流速的ICS受试者。结果表明，较小气道中颗粒的清除是不完全的，并且咳嗽不能完全弥补该区域黏液纤毛运输的缺乏。
