Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis.
Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis.
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DOI：
10.1177/1479972307087190
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发表时间：
2008-01-01
影响因子：
4.1
通讯作者：
Agnew, J E
中科院分区：
文献类型：
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作者：
Hasani, A;Chapman, T H;Agnew, J E
据报道，吸入空气加湿在支气管扩张患者中显示出一定的益处。我们已经研究了一种可能性，即一种效果可能是增强粘膜纤毛清除。如果发生这种情况，这种增强可能有助于减少复发性感染发作的风险。使用放射性气溶胶技术，我们测量了肺粘膜纤毛清除率之前和之后7天的纤毛湿化。患者通过患者操作的加湿鼻吸入系统在37 ℃下吸入高流量饱和空气，每天3小时。我们通过监测6小时的（99 m）Tc标记的聚苯乙烯示踪颗粒的滞留来评估气管支气管粘膜纤毛清除率，并随访24小时的阅读。最初招募的14名患者中有10名（年龄37-75岁; 7名女性）完成了研究（2名在初始筛选后退出，2名在初始清除试验前退出）。研究的7例患者为非吸烟者; 3例为既往吸烟者（1-9包-年）。治疗前和治疗后的初始示踪剂放射性气溶胶分布非常相似。湿化后，肺粘膜纤毛清除率显著改善，气管支气管滞留曲线下面积从319 +/- 50降至271 +/- 46%h（p < 0.07）。暖空气湿化治疗改善支气管扩张患者的肺黏膜纤毛清除。考虑到这一发现以及对湿化机制和效果的实验室和临床兴趣的增加，我们认为需要进一步进行湿化治疗的临床试验，并分析湿化对粘液性质和运输的影响。
Inspired air humidification has been reported to show some benefit in bronchiectatic patients. We have investigated the possibility that one effect might be to enhance mucociliary clearance. Such enhancement might, if it occurs, help to lessen the risks of recurrent infective episodes. Using a radioaerosol technique, we measured lung mucociliary clearance before and after 7 days of domiciliary humidification. Patients inhaled high flow saturated air at 37 degrees C via a patient-operated humidification nasal inhalation system for 3 h per day. We assessed tracheobronchial mucociliary clearance from the retention of (99m)Tc-labelled polystyrene tracer particles monitored for 6 h, with a follow-up 24-h reading. Ten out of 14 initially recruited patients (age 37-75 years; seven females) completed the study (two withdrew after their initial screening and two prior to the initial clearance test). Seven patients studied were non-smokers; three were ex-smokers (1-9 pack-years). Initial tracer radioaerosol distribution was closely similar between pre- and post-treatment. Following humidification, lung mucociliary clearance significantly improved, the area under the tracheobronchial retention curve decreased from 319 +/- 50 to 271 +/- 46%h (p < 0.07). Warm air humidification treatment improved lung mucociliary clearance in our bronchiectatic patients. Given this finding plus increasing laboratory and clinical interest in humidification mechanisms and effects, we believe further clinical trials of humidification therapy are desirable, coupled with analysis of humidification effects on mucus properties and transport.