Ronchi M C, Piragino C, Rosi E, Amendola M, Duranti R, Scano G
Department of Internal Medicine, University of Florence, Italy.
Thorax. 1996 Oct;51(10):1000-4. doi: 10.1136/thx.51.10.1000.
Sputum may provide an alternative source of bronchial cells to investigate characteristics of airway inflammation and its functional correlates in patients with asthma or chronic obstructive pulmonary disease (COPD).
Two groups of clinically stable patients were studied: a group of 43 patients with mild or moderate asthma and a group of 18 patients with COPD. Twenty normal subjects formed a control group. Sputum production was either spontaneous or induced with inhaled hypertonic saline for five minute periods for up to 20 minutes. The concentration of saline was increased at intervals of 10 minutes from 3% to 4%. Plugs from the lower respiratory tract were selected for differential counting in cytocentrifugation preparations. Bronchial provocation tests were performed by inhaling progressive concentrations of histamine from a DeVilbiss 646 nebuliser and the concentration of histamine which caused a 20% fall in the forced expiratory volume in one second (FEV1) was calculated (PC20FEV1).
Neutrophils predominated in the sputum of subjects with COPD while eosinophils predominated in the sputum of those with chronic asthma. However, in 28% of asthmatic subjects an increased percentage of neutrophils was found. In asthmatic patients the differential count of eosinophils was inversely related to the FEV1, FEV1/VC, and bronchial hyperresponsiveness, and directly related to clinical scores.
The cellular profile of sputum in normal subjects and in patients with asthma and COPD is different. The concentration of eosinophils in the sputum correlates with the severity of asthma.
痰液可能为研究哮喘或慢性阻塞性肺疾病（COPD）患者气道炎症特征及其功能相关性提供支气管细胞的替代来源。
研究了两组临床稳定的患者：一组43例轻度或中度哮喘患者和一组18例COPD患者。20名正常受试者组成对照组。痰液产生方式为自然咳出或通过吸入高渗盐水诱导5分钟，最长可达20分钟。盐水浓度每隔10分钟从3%增加到4%。选取下呼吸道的痰液栓子用于细胞离心涂片的分类计数。通过使用德维比斯646雾化器吸入递增浓度的组胺进行支气管激发试验，并计算导致一秒用力呼气量（FEV1）下降20%的组胺浓度（PC20FEV1）。
COPD患者痰液中以中性粒细胞为主，而慢性哮喘患者痰液中以嗜酸性粒细胞为主。然而，在28%的哮喘患者中发现中性粒细胞百分比增加。在哮喘患者中，嗜酸性粒细胞分类计数与FEV1、FEV1/VC及支气管高反应性呈负相关，与临床评分呈正相关。
正常受试者以及哮喘和COPD患者痰液的细胞构成不同。痰液中嗜酸性粒细胞浓度与哮喘严重程度相关。
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