诱导痰(Is)是以高渗盐水或其他诱导物雾化吸入诱导无痰或少痰受检者产生足量痰液,以对气道分泌物的细胞及其他液相成分进行分析研究的一种检测方法,具有经济、无创、准确、重复性较好等优点,能客观地反映气道状态,而且与气道活检的病理改变基本一致,能早期敏感地发现病情变化,并可借此深入研究呼吸系统疾病发病机制及治疗干预。目前,这种检测技术已较成熟,并被广泛应用。 1958年Bickerman等首次建立了诱导痰检测方法,对不能自然咳痰的患者进行高渗盐水雾化获得痰液,利用二硫苏糖醇(DTr)等黏液裂解剂对痰进行处理,消除黏液的影响,提高了肺部肿瘤患者癌细胞的检出率。随后又应用于结核和条件致病菌引发的肺部炎症的诊断。1992年,Pin等首次将诱导痰技术应用于哮喘气道炎症的研究,随后该技术在 COPD、慢性咳嗽、肺间质纤维化等临床研究中得到进一步应用,分析项目也从单一的细胞和病原体等有型成分的检测发展为对痰液液相成分的检测。近年来,越来越多的研究利用诱导痰技术对多种呼吸道疾病的发病机制、诊断与治疗进行研究,逐渐扩大了该技术的应用范围。本文主要阐述诱导痰细胞学检查技术的方法学及临床应用。
Citation:
LUO Wei. Sputum induction:methodologyand clinicalapplicationsinassessment of airways inflammation. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(6): 410-411. doi:
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Pin I,Gibson PG,Kolendowicz R,et al.Use of induced sputum cell counts to investigate airway inflammation in asthma.Thorax,1992, 47·25-29。 2 Fahy JV,Liu J,Wong H,et al.Cellular and biochemical analysis of induced sputum from asthmatic and from heMthy subjects.Am Rev Respir Dis,1993,147:1126-1131.
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中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南 (草案).中华结核和呼吸杂志,2005,28:738-744.
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Paggiaro PL,Chanez P,Holz O,et al.Sputum induction.Eur Respir J,2002,20(Suppl 37):3S一8S.
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赖克方,主编.慢性咳嗽.北京:人民卫生出版社,2008,65-66.
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Spanevello A,Begh6 B,Bianchi A,et al.Comparison of two methods of processing induced sputum:selected versus entire sputum.Am J Respir Crit Care Med,1998,157:665-668.
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Vlachos-Mayer H,Leigh R,Sharon RF,et al.Success and safety of sputum induction in the clinical setting.Eur Respir J,2000,16:997- 1000.
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Anneke ten Brinke,de Lange C,Zwinderman AH,et al.Sputum in· duction in severe asthma by a standardized protoco1.Am J Respir Crit Care Med,2001,164:749-753. 9 Pin I,Gibson PQ,Kolendowicz R,et al.Use of induced sputum cell counts to investigate airw ay inflammation in asthma.Thorax ,1992, 47:25-29.
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Belda J,Leigh R,Parameswaran K,et al.Induced sputum cell counts in healthy adults.Am J Respir Crit Care Med,2000,161:475-478.
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罗炜,赖克方,陈如冲,等.广州地区诱导痰细胞学正常参考值的建立.国际呼吸杂志,2007,27:1213-1215.
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Kim CK,Kim JT,Kang H,et al.Sputum eosinophilia in cough-variant asthma as a predictor of the subsequent development of classic asthma. Clin Exp Allergy,2003,33:1409-1414.
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11. |
罗炜,赖克方,陈如冲,等.诱导痰细胞学检查在慢性咳嗽病因诊断中的应用.中华检验医学杂志,2007,30:280-283.
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- 1. Pin I,Gibson PG,Kolendowicz R,et al.Use of induced sputum cell counts to investigate airway inflammation in asthma.Thorax,1992, 47·25-29。 2 Fahy JV,Liu J,Wong H,et al.Cellular and biochemical analysis of induced sputum from asthmatic and from heMthy subjects.Am Rev Respir Dis,1993,147:1126-1131.
- 2. 中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南 (草案).中华结核和呼吸杂志,2005,28:738-744.
- 3. Paggiaro PL,Chanez P,Holz O,et al.Sputum induction.Eur Respir J,2002,20(Suppl 37):3S一8S.
- 4. 赖克方,主编.慢性咳嗽.北京:人民卫生出版社,2008,65-66.
- 5. Spanevello A,Begh6 B,Bianchi A,et al.Comparison of two methods of processing induced sputum:selected versus entire sputum.Am J Respir Crit Care Med,1998,157:665-668.
- 6. Vlachos-Mayer H,Leigh R,Sharon RF,et al.Success and safety of sputum induction in the clinical setting.Eur Respir J,2000,16:997- 1000.
- 7. Anneke ten Brinke,de Lange C,Zwinderman AH,et al.Sputum in· duction in severe asthma by a standardized protoco1.Am J Respir Crit Care Med,2001,164:749-753. 9 Pin I,Gibson PQ,Kolendowicz R,et al.Use of induced sputum cell counts to investigate airw ay inflammation in asthma.Thorax ,1992, 47:25-29.
- 8. Belda J,Leigh R,Parameswaran K,et al.Induced sputum cell counts in healthy adults.Am J Respir Crit Care Med,2000,161:475-478.
- 9. 罗炜,赖克方,陈如冲,等.广州地区诱导痰细胞学正常参考值的建立.国际呼吸杂志,2007,27:1213-1215.
- 10. Kim CK,Kim JT,Kang H,et al.Sputum eosinophilia in cough-variant asthma as a predictor of the subsequent development of classic asthma. Clin Exp Allergy,2003,33:1409-1414.
- 11. 罗炜,赖克方,陈如冲,等.诱导痰细胞学检查在慢性咳嗽病因诊断中的应用.中华检验医学杂志,2007,30:280-283.