甘露醇对黏液纤毛清除功能受损疾病的作用

Effects of mannitol on disorders of mucociliary dysfunction

甘露醇干粉吸入剂是一种高渗性物质，进入气道后，形成渗透压阶梯，促进水分向气道腔扩散。这一过程不仅增加纤毛周围液体层厚度，而且水化黏液，使黏液的流变学特性发生改变，从而易化黏液纤毛清除。应用于黏液高分泌伴黏液纤毛清除功能受损的疾病，甘露醇能够改善其气道环境，减少黏液沉积及黏液栓形成，减轻症状，改善肺功能，减少细菌定植及慢性感染导致疾病加重的机会，最终提高患者生活质量。因此，它可能成为一种具有潜力的治疗黏液高分泌疾病的药物。临床试验已经证明其短期效果较佳，但长期效果尚待进一步的临床试验验证。

Mannitol is a hyperosmolar agent and creates an osmolar gradient in the airway after being inhaled, which induces water flux into bronchial lumen. Thereafter, not only periciliary fluid depth is optimized but also mucus is hydrated. This event changes the surface properties of mucus and facilitates mucociliary clearance. When applied to disorders of mucus hypersecretion with impaired mucociliary clearance,it maintains airway hygiene by reducing mucus retention and subsequent mucus plug formation. Then patients＇ symptoms are eliminated, lung function is improved, bacterial colonization and exacerbation of chronic infection are reduced, and eventually life quality is improved. Therefore, it is considered to be a potential therapy for the disorders. Short-term studies have shown significant clinical outcomes, while longterm efficacy still needs to be approved.