摘要
气道表面液体(ASL)的高渗已被认为是刺激高通气诱导的哮喘。我们之前发现,在干燥空气下等co2吸入过度通气(ISH)后,黏液纤毛清除率(MCC)增加,我们认为这种增加与肌萎缩肌萎缩肌短暂性高渗血症有关。我们研究了增加ASL的渗透压浓度对MCC的影响,通过给药的浓缩盐溶液气溶胶。用99mtc -硫胶体、伽玛相机和计算机分析分别对12例哮喘患者和10例健康者进行3天的MCC测定,包括:1)超声雾化14.4%生理盐水;2)超声雾化0.9%生理盐水;3)无气溶胶干预(控制)。哮喘患者雾化14.4%生理盐水的(平均+/- SD)体积为2.2 +/- 1.2 mL,健康受试者为3.2 +/- 0.7 mL。该容积分别用于哮喘和健康受试者,时间分别为5.4 +/- 1.3和6.4 +/- 0.7 min。对14.4%生理盐水的气道反应进行了单独评估,哮喘患者1秒用力呼气量(FEV1)下降22 +/- 4%,健康受试者3 +/- 2%。与0.9%生理盐水组和对照组相比,高渗气雾剂均使MCC升高。 In asthmatic subjects, MCC of the whole right lung in 1 h was 68 +/- 10% with 14.4% saline vs 44 +/- 14% with 0.9% saline and 39 +/- 13% with control. In healthy subjects, MCC of the whole right lung in 1 h was 53 +/- 12% with 14.4% saline vs 41 +/- 15% with 0.9% saline and 36 +/- 13% with control. We conclude that an increase in osmolarity of the airway surface liquid increases mucociliary clearance both in asthmatic and healthy subjects. These findings are in keeping with our previous suggestion that the increase in mucociliary clearance after isotonic hyperventilation with dry air is due to a transient hyperosmolarity of the airway surface liquid.