间质性肺疾病支气管肺泡灌洗液的酶活性研究

A study on enzymatic activities of bronchoalveolar lavage fluid in patients with interstitial lung diseases

目的探讨支气管肺泡灌洗液（ＢＡＬＦ）多项酶活性与间质性肺疾病（ＩＬＤ）的关系。方法检测３０例ＩＬＤｓ：包括特发性肺纤维化（ＩＰＦ）１８例和结节病（Ｓａｒｃ）１２例与９例正常对照者的ＢＡＬＦ中超氧化歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－ＰＸ）、血管紧张素转换酶（ＡＣＥ）和乳酸脱氢酶（ＬＤＨ）活性，并分类计数ＢＡＬＦ细胞成份。结果（１）ＩＰＦ组ＢＡＬＦ中各项酶活性均与对照组间差异有显著性（ＳＯＤ和ＧＳＨ－ＰＸ降低，ＡＣＥ和ＬＤＨ升高）（Ｐ＜０．０５）；而Ｓａｒｃ组仅见ＡＣＥ明显增高（Ｐ＜０．０５）。（２）ＢＡＬＦ－ＡＣＥ与Ｓａｒｃ组淋巴细胞百分比及ＣＤ＋４／ＣＤ＋８比值均有显著线性相关（Ｐ＜０．０５）。结论ＢＡＬＦ中ＳＯＤ、ＧＳＨ－ＰＸ、ＡＣＥ和ＬＤＨ活性测定，有助于进一步探讨ＩＬＤ发病机理和提供辅助诊断依据，ＢＡＬＦ－ＡＣＥ对判断Ｓａｒｃ活动性有重要临床意义。

Objective To evaluate the relationship between enzymatic activities in bronchoalveolar lavage fluid(BALF) and interstitial lung diseases(ILDs). Method Cellular components and levels of superoxide dismutase (SOD), glutathione peroxidase(GSH PX) , angiotensin converting enzyme(ACE) and lactate dehydrogenase(LDH) in BALF in 30 cases of ILDs: including 18 patients with idiopathic pulmonary fibrosis (IPF) and 12 patients with sarcoidosis (Sarc) and 9 healthy controls were determined. Result (1)The levels of BALF SOD, GSH PX were significantly decreased( P <0.01), and BALF ACE, LDH were markedly increased ( P <0.05) in patients with IPF, and BALF ACE were also increased in patients with Sarc( P < 0.05 ); (2) There were good correlation between ACE and percentage of lymphocyte ( r 1=0.6574, P <0.05 ), and ratio of CD + 4/CD + 8( r 2=0.9544, P <0.001)in BALF of Sarc group. Conclusion Determing enzymatic activities could be helpful to study pathogenesis and diagnosis of ILDs, BALF ACE may be as a good marker of disease activity of Sarcoidosis.