摘要
目的:观察缓解期哮喘和稳定期中、重度慢性阻塞性肺疾病(COPD)患者吸入高渗盐水诱导痰的安全性和有效性。方法:吸入沙丁胺醇200μg后10m in吸入3%的高渗盐水诱导痰。观察16例哮喘患者、14例COPD患者和11例健康对照者诱导痰前、后肺功能、心率(HR)、呼吸频率(RR)、血氧饱和度(SaO2)和不良反应,做诱导痰炎性细胞分类计数。夹心法酶联免疫吸附实验(ELISA)测定诱导痰上清液中白细胞介素-5(IL-5)的含量。结果:哮喘和COPD患者诱导痰前后肺功能、HR、RR和SaO2均无显著变化(P>0.05)。哮喘组患者诱导痰中嗜酸性粒细胞数(16.3±7.2)%显著高于对照组(0.7±0.6)%和COPD组(6.5±5.4)%(P<0.05),而COPD组患者诱导痰中中性粒细胞数(59.4±10.6)%显著高于对照组(25.1±6.1)%和哮喘组(28.7±7.3)%(P<0.05)。哮喘组诱导痰中IL-5水平(53.3±24.2)ng/L显著高于对照组(20.2±4.1)ng/L和COPD组(29.8±4.7)ng/L(P<0.05)。COPD组患者中性粒细胞数的百分比与基础第1秒用力肺活量(FEV1)间呈负相关(r=-0.58,P<0.05)。哮喘组和COPD组不良反应发生率分别为31.25%和42.86%,但轻微且均能耐受。结论:缓解期哮喘和稳定期中、重度COPD患者吸入高渗盐水进行痰的诱导是安全的。诱导痰的分析能反映哮喘和COPD的气道炎症特征。
Objective ： To investigate the safety and effectivity of hypertonic saline on sputum induction in patients with asthma in remission stages and moderate-severe stable chronic obstructive pulmonary disease（COPD）. Methods：All subjects inhaled 3% hypertonic saline for sputum induction at 10 minutes after inhalation of 200μg salbutamol. Changes of lung function , heart rate （ HR）, respiratory rate （ RR）, saturation of blood oxygen （ SaO2 ）, and the side-effects after sputum induction were observed in 16 asthmatics ,in 14 COPD patients and in 10 healthy volunteers. The differential counts of sputum inflammatory cells were studied. The interleukin-5 （IL-5） in sputum supernatants was detected using enzyme-linked immunosorbent assay （ELISA）. Results ： No significant differences in lung function, HR, RR and SaO2 after sputum induction were found in patients with asthma and COPD （ P 〉 0.05 ）. The percentage of eosinophils in induced sputum in asthmatics （ 16.3 ± 7.2） % was higher than those in healthy volunteers （0.7 ± 0.6 ） % and in COPD （6.5 ± 5.4） % （ P 〈 0.05 ）. The percentage of neutrophil in induced sputum in COPD （59.4 ± 10.6）% was higher than those in healthy volunteers （25.1 ± 6.1 ） % and in asthmatics （28.7 ± 7.3） % （P 〈 0.05 ）. The level of IL-5 in induced sputum in asthmatics （53.3 ± 24.2 ） ng/L was higher than those in healthy volunteers （ 20.2 ± 4. 1 ） ng/L and in COPD （29.8 ±4.7 ）ng/L（P 〈0.05）. the percentage of neutrophil in induced sputum in COPD correlated inversely with baseline forced expiratory volume in one second （FEV1） （r = -0.58, P 〈 0.05）. The side-effect rates were 31. 25% and 42. 86% respectively in patients with asthma and COPD,but the degree was mild and well tolerated. Conclusion：Sputum induction after inhalation of salbutamol are safe in patients with asthma in remission stages and moderate -severe stable COPD. The analysis of induced sputum can reflect the characteristic of airway
出处
《医学研究生学报》
CAS
2006年第7期616-619,共4页
Journal of Medical Postgraduates
基金
江苏省"六大人才高峰重点课题"基金资助项目(批准号:2005A6)
关键词
哮喘
慢性阻塞性肺疾病
高渗盐水
诱导痰
Asthma
Chronic obstructive pulmenary disease
Hypertonic saline
Sputum induction
