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引用次数: 0
摘要
呼吸稳态是一个精细的调节系统,很大程度上依赖于上呼吸道和下呼吸道对吸入物质的清除。研究最少的是肺泡清除率,然而,它对正常的肺功能至关重要,需要详细的检查,以提高肺部疾病的诊断和治疗的准确性。在这里,我分析了来自公共数据库(Index Medicus, PubMed, Embase, Cochrane Library, ClinicalTrials.gov, Google Patents)的相关文献,比较了测定肺泡清除率的各种方法,它们的优点和缺点,它们在常规临床实践中的适用性以及它们的应用前景。支气管肺泡灌洗和支气管肺泡灌洗液研究是评估肺泡清除率最方便、信息最丰富、最便宜的方法。激光共聚焦内镜是一种新型的、功能强大的成像方式,但迄今尚未得到广泛应用。无创吸入放射性气溶胶示踪剂用于研究体内肺泡清除似乎很有希望,但仍需要适应广泛使用。
Assessment of the alveolar clearance: a critical review
Respiratory homeostasis is fine-tuned system largely dependent on the clearance of inhaled substances from both upper and lower airways. The least studied is alveolar clearance, which, however, is crucial for the proper lung function and requires a detailed examination in order to improve the accuracy of diagnosis and treatment of lung diseases. Here, I analysed relevant literature from publicly available databases (Index Medicus, PubMed, Embase, Cochrane Library, ClinicalTrials.gov, Google Patents) to compare various methods for determining alveolar clearance, their advantages and shortcomings, their applicability in routine clinical practice and prospects for their use. The most accessible, informative, and inexpensive method to assess the alveolar clearance is bronchoalveolar lavage and the study of bronchoalveolar lavage fluid. Confocal laser endomicroscopy, a new and powerful imaging modality, has not been widely implemented hitherto. A non-invasive inhalation of a radioaerosol tracer for studying alveolar clearance in vivo seems to be promising but still requires adaptation for the broad use.