Erythromycin was administered to the patients for 9.3 ±0.8 months. After the treatment, H influenzae was eradicated in three patients but replaced by P aeruginosa in one case. In all 3 patients originally exhibiting P aeruginosa in cultures, the organism was eradicated. In the one patient (case 1) with S aureus, this organism was eradicated, but replaced by H influenzae. In one of the patients with normal flora, these were replaced by H influenzae; in the other such patient, these flora were replaced by P aeruginosa. The bacteria eradication rate was 75.0 percent (6/8).
The mean values for respiratory function parameters and arterial blood gas analysis before and after EM treatment are shown in Table 2. After EM treatment, the mean values for four parameters of respiratory function were markedly improved, ie, percent VC increased from 72.7 ±4.5 percent to 90.0 ±4.3 percent (p<0.01), FEV 1.0 percent from 68.6 ±4.2 percent to 75.2 ±4.0 percent (p<0.05), percent carbon monoxide diffusion capacity in the lungs (DLCO) from 55.8 ±3.8 percent to 69.6 ±3.9 percent (p<0.05) and V25/HT from 0.2 ±0.1 L/s/m to 0.5±0.1 L/s/m (p<0.05). There were no significant changes in the other parameters after EM therapy asthma inhaler.
The mean values for BAL parameters before and after EM therapy are shown in Table 3. The mean values for total cell number and neutrophil percentage before EM treatment were significantly higher than values in healthy volunteers; the values were significantly reduced after EM therapy (p<0.05), corresponding with an improvement in clinical symptoms and findings. Changes in the recovery rate pre-and post-EM treatment were not significant (48.3 ± 4.3 vs 46.5 ±5.9 percent). Figure 1 shows the changes in NCA pre- and post-EM treatment in the BAL fluid of patients with DPB. The mean NCA value before EM treatment was 52.9 ±2.9 percent; and there was a marked reduction in this value after the treatment (30.8 ± 2.5 percent, p<0.001). There were no significant differences between values for albumin concentration in initial BAL fluid samples and in repeated samples (41.8 ±10.8 vs 39.3 ±6.8 mg/dl, p=0.85).
Table 2—Respiratory Function in 13 DPB Patients
|Pre-EM||Post-EM||Paired t Test|
|%vc||72.7 ±4.5||90.0 ±4.3||p<0.01|
|FEV 1.0, %||68.6 ±4.2||75.2 ±4.0||p<0.05|
|RV/TLC, %||40.4 ±2.7||34.9 ±2.1||NS|
|%DLCO||55.8 ±3.8||69.6 ±3.9||p<0.05|
|DLCO/VA, ml/min/mm Hg||2.9±0.2||3.2±0.3||NS|
|V25/HT, l/s/m||0.2 ±0.1||0.5 ±0.1||p<0.05|
|РаОг, mm Hg||75.7 ±4.0||83.2 ±2.5||NS|
Table 3—BAL Findings in the IS DPB Patients
|Pre-EM||Post-EM||Paired t Test|
|Recovery rate, %||48.3 ±4.3||46.5 ±5.9||NS|
|Total, X105/ml||8.0± 1.7||3.5 ±0.8||p<0.05|
|AMf, %||28.2 ±7.2||50.3 ±8.3||p<0.05|
|Lym, %||13.9±2.4||16.2 ±2.9||NS|
|Neu, %||57.2 ±8.4||32.7 ±9.6||p<0.05|
|Eo, %||0.6 ±0.3||0.8 ±0.3||NS|
Figure 1. Total neutrophil chemotactic activity in pre- and post-EM treatment BAL fluid obtained from 13 patients with diffuse panbronchiolitis and from 5 healthy nonsmoking volunteers (HV). NCA, assessed by the blindwell chamber technique is expressed as a percentage of the chemotactic response to 10-7 mol/L N-formyl-methionyl-leucyl-phenylalanine. Each value represents mean ± standard error. Shaded area shows background activity of this assay using Hank’s solution. The chemotactic activity in pre-EM treatment BAL fluid obtained from the DPB patients is significantly elevated compared with that of the HV. The chemotactic activity of BAL fluid from the DPB patients was significantly reduced after EM treatment (p<0.001).