Ericsson C H, Svartengren K, Svartengren M, Mossberg B, Philipson K, Blomquist M, Camner P
Dept of Respiratory Medicine and Allergology, Karolinska Institute, Stockholm Söder Hospital, Sweden.
Eur Respir J. 1995 Nov;8(11):1886-93. doi: 10.1183/09031936.95.08111886.
Previous investigations on tracheobronchial clearance in chronic bronchitis or chronic obstructive pulmonary disease (COPD) have usually referred to measurements during a short time-period, i.e. a few hours. The purpose of this study, therefore, was to study regional particle deposition and tracheobronchial clearance during 72 h. In 14 patients with chronic bronchitis clearance of 111In-labelled 3.6 micrograms Teflon particles and lung function were measured on two occasions, with an interval of 2 weeks. Lung retention of test particles was measured at 0, 24, 48 and 72 h using a profile scanner. The weight of expectorated sputum samples was measured after the two clearance measurements. The particle retentions at all time-points were reproducible, as seen from the two measurements ( r > 0.90). The fast clearance phase was completed within 72 h. No correlation between sputum volume and clearance was seen. There was a significant negative correlation between airway resistance and the 72 h retention (r= -0.66), and an even better correlation between specific airway resistance and the 72 h retention (r = -0.82), indicating more central deposition in obstructed airways. There was no significant correlation between lung function tests reflecting smaller airways and the 72 h retentions. Deposition data agreed well with theoretical calculations and experimental data in healthy subjects. In spite of earlier findings that mucociliary transport is usually severely impaired in chronic bronchitis and COPD, the present results indicate that overall tracheobronchial mucus clearance in these patients is fairly effective, probably due to a productive cough. Alveolar deposition may be estimated by measurements of the 72 h retention in subjects with chronic obstructive pulmonary disease. The 72 h retention is dependent mainly on the calibre of larger airways. The present method of studying airway clearance during 3 days is highly reproducible.
以往针对慢性支气管炎或慢性阻塞性肺疾病（COPD）患者气管支气管清除功能的研究通常是在短时间内，即几个小时内进行测量。因此，本研究的目的是研究72小时内的局部颗粒沉积和气管支气管清除功能。对14例慢性支气管炎患者，两次测量间隔2周，测量了111铟标记的3.6微克聚四氟乙烯颗粒的清除率和肺功能。使用轮廓扫描仪在0、24、48和72小时测量试验颗粒的肺潴留量。在两次清除率测量后测量咳出痰液样本的重量。从两次测量结果可以看出，所有时间点的颗粒潴留量都具有可重复性（r>0.90）。快速清除阶段在72小时内完成。未观察到痰量与清除率之间的相关性。气道阻力与72小时潴留量之间存在显著负相关（r = -0.66），比气道阻力与72小时潴留量之间的相关性更好（r = -0.82），表明在阻塞气道中颗粒沉积更集中于中央部位。反映小气道功能的肺功能测试与72小时潴留量之间无显著相关性。沉积数据与健康受试者的理论计算和实验数据吻合良好。尽管早期研究发现慢性支气管炎和COPD患者的黏液纤毛运输通常严重受损，但目前的结果表明，这些患者的气管支气管黏液总体清除功能相当有效，可能是由于咳嗽有痰。对于慢性阻塞性肺疾病患者，可通过测量72小时潴留量来估计肺泡沉积情况。72小时潴留量主要取决于较大气道的管径。目前这种研究3天内气道清除功能的方法具有高度可重复性。
