Pizzichini M M, Popov T A, Efthimiadis A, Hussack P, Evans S, Pizzichini E, Dolovich J, Hargreave F E
Asthma Research Group, Department of Medicine, St. Joseph's Hospital, Hamilton, Ontario, Canada.
Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):866-9. doi: 10.1164/ajrccm.154.4.8887576.
Inhalation of hypertonic saline to induce sputum may alter cells and fluid-phase markers in sputum. We have compared indices of inflammation in sputum produced spontaneously with sputum induced by an aerosol of hypertonic saline. Twenty-three asthmatics produced spontaneous followed by induced sputum on the same day. The sputum specimen was separated from saliva within 2 h, dispersed with dithiothreitol (DTT) and processed to obtain cytospins and supernatant. The statistical power to detect a 20% difference in sputum parameters was > 90%. Results are expressed as median and interquartile range [IQR]. Induced sputum had a higher proportion of viable cells (77.0 [19.0] versus 47.0 [38.0]%, p < 0.001), less squamous cell contamination (1.0 [1.2] versus 1.8 [34.0]%, p < 0.001) and better quality cytospins (score of 8.0 [4.0] versus 4.0 [2.0], p < 0.001). It also had lower fluid-phase levels of eosinophil cationic protein (ECP) (1,358 [1,102] versus 1,574 [2,479] microg/L) and fibrinogen (1,560.0 [3,130.0] versus 4,350.0 [5,970.0] ng/ml) but only the latter was significantly different (p = 0.02). Induced sputum was similar to spontaneous sputum in weight (200.0 [219.0] versus 270.0 [227.0] mg), total cell count (3.3 [4.1] versus 3.5 [4.5] x 10(6)/ml), proportion of nonsquamous cells, and levels of tryptase. The agreement between induced and spontaneous measurements was good, but fluid-phase levels were affected by the low viability of some spontaneous samples. We conclude that for the indices measured in asthmatic subjects, induced sputum separated from saliva is similar to lower respiratory secretions expectorated spontaneously and has the advantage of better cell viability.
吸入高渗盐水诱导痰液可能会改变痰液中的细胞和液相标志物。我们比较了自发性痰液与高渗盐水气雾剂诱导产生的痰液中的炎症指标。23名哮喘患者在同一天先咳出自发性痰液，随后诱导出痰液。痰液标本在2小时内与唾液分离，用二硫苏糖醇（DTT）分散，并进行处理以获得细胞涂片和上清液。检测痰液参数20%差异的统计功效>90%。结果以中位数和四分位数间距[IQR]表示。诱导痰液中活细胞比例更高（77.0[19.0]%对47.0[38.0]%，p<0.001），鳞状细胞污染更少（1.0[1.2]%对1.8[34.0]%，p<0.001），细胞涂片质量更好（评分8.0[4.0]对4.0[2.0]，p<0.001）。其嗜酸性粒细胞阳离子蛋白（ECP）的液相水平也较低（1358[1102]对1574[2479]μg/L）和纤维蛋白原（1560.0[3130.0]对4350.0[5970.0]ng/ml），但只有后者有显著差异（p=0.02）。诱导痰液在重量（200.0[219.0]对270.0[227.0]mg）、总细胞计数（3.3[4.1]对3.5[4.5]×10⁶/ml）、非鳞状细胞比例和类胰蛋白酶水平方面与自发性痰液相似。诱导测量与自发测量之间的一致性良好，但液相水平受一些自发样本低活力的影响。我们得出结论，对于哮喘患者中测量的指标，从唾液中分离出的诱导痰液与自发咳出的下呼吸道分泌物相似，并且具有细胞活力更好的优势。
