USE OF INDUCED SPUTUM CELL COUNTS TO INVESTIGATE AIRWAY INFLAMMATION IN ASTHMA
USE OF INDUCED SPUTUM CELL COUNTS TO INVESTIGATE AIRWAY INFLAMMATION IN ASTHMA
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DOI：
10.1136/thx.47.1.25
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发表时间：
1992-01-01
期刊：
影响因子：
10
通讯作者：
DOLOVICH, J
中科院分区：
文献类型：
--
作者：
PIN, I;GIBSON, PG;DOLOVICH, J
背景气道炎症被认为在哮喘中很重要，但相对难以研究。方法对17例哮喘患者和17例不能自发产生痰的正常人采用改良的吸入高渗盐水诱导痰的方法。对该方法的成功率和安全性、细胞计数的重复性以及哮喘组和正常组之间细胞计数的差异进行了检查。吸入沙丁胺醇后，吸入3-5%高渗盐水溶液长达30分钟。要求受试者每五分钟吐一次痰。样本的质量根据栓塞的体积和唾液污染的程度进行评分。从下呼吸道的塞子被选中的总细胞计数和嗜酸性粒细胞和异染性细胞（肥大细胞和嗜碱性粒细胞）在直接smears.Results足够的样本从下呼吸道获得76%的第一次尝试的差异细胞计数。在吸入生理盐水期间，第一秒用力呼气量（FEV 1）平均下降5.3%，最大下降20%。嗜酸性粒细胞和异染性细胞计数具有重现性（可靠性系数分别为0.8和0.7）。与正常人痰液相比，哮喘患者痰液中嗜酸性粒细胞（平均18.5%（SE 3.8%）v1.9%（0.6%））和异染性细胞（0.50%（0.18%）v0.039%（0.014%））的比例显著较高。哮喘组嗜酸性粒细胞计数与基线FEV 1相关。结论诱导痰能检测正常人和哮喘患者的嗜酸性粒细胞计数差异，可作为评估哮喘气道炎症的潜在方法。
Background Airway inflammation is considered to be important in asthma but is relatively inaccessible to study. Less invasive methods of obtaining sputum from patients unable to produce it spontaneously should provide a useful investigational tool in asthma.Methods A method to induce sputum with inhaled hypertonic saline was modified for use in 17 asthmatic patients and 17 normal subjects who could not produce sputum spontaneously. The success rate and safety of the method, the reproducibility of cell counts, and differences in cell counts between the asthmatic and normal groups were examined. Hypertonic saline solution 3-5% was inhaled for up to 30 minutes after inhalation of salbutamol. Subjects were asked to expectorate sputum every five minutes. The quality of the sample was scored on the volume of plugs and the extent of salivary contamination. Plugs from the lower respiratory tract were selected for a total cell count and for differential cell counts of eosinophils and metachromatic cells (mast cells and basophils) in direct smears.Results Adequate samples from the lower respiratory tract were obtained in 76% of first attempts. The mean fall in the forced expiratory volume in one second (FEV1) during inhalation of saline was 5.3% and the maximum fall 20%. Eosinophil and metachromatic cell counts were reproducible (reliability coefficient 0.8 and 0.7 respectively). When compared with sputum from normal subjects sputum from asthmatic patients contained a significantly higher proportion of eosinophils (mean 18.5% (SE 3.8%) v 1.9% (0.6%)) and metachromatic cells (0.50% (0.18%) v 0.039% (0.014%)). In the asthmatic group the differential eosinophil count correlated with the baseline FEV1.Conclusion Induced sputum is capable of detecting differences in cell counts between normal and asthmatic subjects and merits further development as a potential means of assessing airway inflammation in asthma.