抽象的
痰液检查越来越多地用作评估气道炎症的非侵袭性方法。咳痰痰液具有唾液可变污染。处理方法包括,所认为肺源代表的样品的部分选择与整个样本的使用,这通过不同的唾液体积混淆。我们将细胞谱和嗜酸性阳离子蛋白(ECP)浓度与选自屈光率选择的痰和通常丢弃的残余部分进行比较,以确定最小化唾液污染的程度,并且如果结果代表较低呼吸分泌物。用高渗盐水在六个健康和九个哮喘受试者中诱导痰。被认为是纯低呼吸道源的所有部分选自残余物。选择的和残留部分用二硫醇处理,得到总细胞计数和细胞活力,对差异细胞计数进行细胞螺旋素,收集上清液用于ECP测定。与残留部分相比,样本的选定部分显示:鳞状细胞污染少(中位数1.2与70%; P <0.001);更高的总细胞计数.ML-1(5.1 Vs 0.5×10(6)细胞.ML-1; P <0.001);每个样品的可行性不良细胞数量越多(1.9 Vs 0.6×10(6)个细胞; P <0.001); higher slide quality score (7 vs 4; p < 0.001); and higher levels of ECP (768 vs 136 micrograms.L-1; p < 0.001). There were no differences in the differential cell counts of eosinophils (1.3 vs 3.8%), neutrophils (44 vs 32%), and lymphocytes (0.6 vs 0.6%). While the proportion of macrophages was lower (36 vs 54%; p < 0.05), the absolute number (41 vs 19 x 10(4) cells; p < 0.05) was higher in the selected portion. In summary, selection of all portions of induced sputum from the expectorate minimized the confounding influence of saliva. Loss of nonsquamous cells in the residual portion was variable but usually less than one third of those in the selected portion. With one exception, this loss had little influence on the differential counts of inflammatory cells. Similar observations apply to eosinophilic cationic protein levels. We conclude that, in healthy subjects and treated asthmatics, inflammatory markers in the selected portion of the expectorate can be used to represent those in the lower respiratory tract in general.