矽肺病患者痰液的诱导方法

Study on Optimizing the Sputum Induction Processes in Patient with Silicosis

[目的]通过优化痰液诱导和处理条件,探讨适宜的痰液诱导和处理方法。[方法]以不同浓度的高渗盐溶液、不同诱导时间对40例Ⅰ期矽肺患者进行雾化痰液诱导;用不同稀释倍数的0.1%二硫苏糖醇（DTT）及不同的水浴时间对痰液进行处理。[结果]3%、4%、5%浓度高渗盐水诱导成功率分别为80.00%、82.50%、60.00%;而6%浓度仅为22.50%,明显低于3%、4%、5%溶液（P〈0.01）;4%、5%之间的差异有统计学意义（P〈0.05）;3%、4%之间的差异无统计学意义（P〉0.05）。3%浓度高渗盐水诱导时间25、30 min的成功率分别为77.50%、92.50%。痰液37℃水浴30、40、50 min溶解状况明显优于20 min,差异有统计学意义（P〈0.05）;而30 min、40 min、50 min水浴差异无统计学意义（P〉0.05）。4倍DTT与2倍体积DTT稀化对痰液溶解状况及痰液中IL-6和TNF-α水平均无明显影响（P〉0.05）。[结论]以3%、4%的高渗盐水雾化吸入20、30 min痰液诱导满意率较高且得到的痰液质量较佳,经过水浴30-40 min,加入2倍或4倍0.1%DTT处理的稀化程度较好。

[Objective] To optimizing the solution concentration and procedures of pre-treatment in sputum analyses among patient with respiratory disease.[Methods] Results of sputum induction with various solution and treatment in 40 patients with silicosis were compared.[Results] Success result of sputum induction was obtained in rates of 80.00%,82.50%,60.00%,and 22.50% from inhalation of mist of 3%,4%,5%,and 6% hypertonic saline solution respectively.The differences between 4% and 5% to all others were statistically significant（P〈0.05）.Rate of successful result for 25 to 30 min.induction were 77.50% and 92.50%,respectively.Better result in dissolution and no influence level in detecting IL-6 and TNF-α were obtained from 30-50 min 37 ℃ water bath than less than 20 min.in 2-4 fold dilution of 0.1% DTT（P〉0.05）.[Conclusion] The optimized condition for sputum induction was find of spraying mist of 3%-4% hypertonic saline for 20-30 min.Better consequent pre-treatment was 37℃ water bath incubation in 2-4 folds dilution with 0.1% DTT solution for 30-40 min.