特发性肺纤维化病人支气管肺泡灌洗液中细胞外基质的变化

CHANGES OF EXTRACELLULAR MATRIX COMPONENTS IN BRONCHOALVEOLAR LAVAGE FLUID IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS

为探讨细胞外基质在肺纤维化中的作用，检测了１３例特发性肺纤维化（ＩＰＦ）病人和１１例正常人支气管肺泡灌洗液（ＢＡＬＦ）和外周血中纤维连接素（ＦＮ）、透明质酸（ＨＡ）和Ⅲ型前胶原（ＰＣⅢ）水平。结果：（１）ＩＰＦ组ＢＡＬＦ中ＦＮ、ＨＡ和ＰＣⅢ水平分别较外周血明显升高，并且也分别高于对照组ＢＡＬＦ中的水平；（２）ＩＰＦ组ＢＡＬＦ中的ＦＮ和ＨＡ均分别与细胞总数和中性粒细胞数（％）呈正相关，而ＰＣⅢ与肺泡巨噬细胞总数呈正相关。另外，ＦＮ、ＨＡ、ＰＣⅢ之间均呈明显的正相关。结果提示：ＩＰＦ病人肺内ＦＮ、ＨＡ和ＰＣⅢ产生增多；ＢＡＬＦ中ＦＮ、ＨＡ和ＰＣⅢ的水平从不同侧面反映了疾病活动性并具有估计预后的作用。

To clarify the roles of extracellular matrix in pulmonary fibrosis, we determined the levels of fibronectin(FN),hyaluronan(HA) and procollagenⅢ (PCⅢ) in peripheral blood and in bronchoalveolar lavage fluid(BALF) in 13 patients with idiopathic pulmonary fibrosis (IPF) and 11 normal subjects. The levels of FN, HA and PCⅢ in BALF in patient group were not only significantly higher than those in own peripheral blood, but also significantly higher than those in BALF in control group. In patient group,the levels of FN and HA in BALF were respectively correlated with total cell numbers and neutrophils. PCⅢ levels were related to alveolar macrophages.Also,there were positive correlation between FN,HA and PCⅢ in BALF.These results suggested that the productions of FN,HA and PCⅢ within the lung in IPF were increased and that the levels of FN, HA and PCⅢin BALF might reflect the activity of the disease from different aspects and play a role in estimating prognosis.