acute inhalation of hypertonic saline does not improve mucociliary clearance in all children with cystic fibrosis急性吸入高渗盐水不能改善黏膜纤毛的清除与囊性纤维化所有儿童.pdfVIP

Laube et al. BMC Pulmonary Medicine 2011, 11:45 /1471-2466/11/45 RESEARCH ARTICLE Open Access Acute inhalation of hypertonic saline does not improve mucociliary clearance in all children with cystic fibrosis * Beth L Laube, Gail Sharpless, Kathryn A Carson, Amber Kelly and Peter J Mogayzel Jr Abstract Background: Little is known of how mucociliary clearance (MCC) in children with cystic fibrosis (CF) and normal pulmonary function compares with healthy adults, or how an acute inhalation of 7% hypertonic saline (HS) aerosol affects MCC in these same children. Methods: We compared MCC in 12 children with CF and normal pulmonary function after an acute inhalation of 0.12% saline (placebo), or HS, admixed with the radioisotope 99 mtechnetium sulfur colloid in a double-blind, randomized, cross-over study. Mucociliary clearance on the placebo day in the children was also compared to MCC in 10 healthy, non-CF adults. Mucociliary clearance was quantified over a 90 min period, using gamma scintigraphy, and is reported as MCC at 60 min (MCC60) and 90 min (MCC90). Results: Median [interquartile range] MCC60 and MCC90 in the children on the placebo visit were 15.4 [12.4- 24.5]% and 19.3 [17.3-27.8%]%, respectively, which were similar to the adults with 17.8 [6.4-28.7]% and 29.6 [16.1- 43.5]%, respectively. There was no significant improvement in MCC60 (2.2 [-6.2-11.8]%) or MCC90 (2.3 [-1.2-10.5]%) with HS, compared to placebo. In addition, 5/12 and 4/12 of the children showed a decrease in MCC60 and MCC90, respectively, after inhalation of HS. A post hoc subgroup analysis of the change in MCC90 after HS showed a significantly greater improvement in MCC in children with lower placebo MCC90 compared to those with higher pl