哮喘、慢支和过敏性肺炎的支气管肺泡灌洗液细胞学分析

DIFFERENTLATION OF CYTOLOGY IN BALF OF ASTHMA, CHRONIC BRONCHITIS AND HYPERSENSITIVITY PNEUMONITIS

目的：为了解支气管肺泡灌洗液（BALF）细胞学在哮喘、慢性支气管炎（慢支）和过敏性肺炎（HP）的特征。方法：分别对16例哮喘，15例慢支，16例过敏性肺炎患者的BALF中细胞分类计数、T淋巴细胞亚群及HLA－DR进行了测定。结果：哮喘患者BALF中嗜酸细胞及淋巴细胞表面HLA－DR明显高于慢支和过敏性肺炎组（P＜0．01）；过敏性肺炎的淋巴细胞、CDS8+细胞明显高于哮喘和慢支组（P＜0．01）；慢支组中性粒细胞明显高于哮喘和过敏性肺炎组（P＜0．01）。结论：测定BALF中细胞分类计数、T细胞亚群及HLA－DR，对鉴别哮喘、慢支和过敏性肺炎有指导作用，对研究各自不同的病理生理学过程也可提供有益的线索。

Objective:To study cytology stud in bronchoalveolar lavage fluid (BALF) from patients with asthma, chronic bronchitis (CB) and hypersensitivity pneumonitis (HP). Methods: Different cell count, T-cell subpopulation and lymphocytes expressing HLA-DR molecular of the BALF obtained from 16 patients with asthma, 15 patients with CB and 16 patients with HP were determined. Results: In asthma,the ratio of eosinophilia and lymphocytes expressing HLA-DR in BALF were significantly higher than those in CB and HP (P <0. 01 ). In HP,the ratio of lymphocytes and CD8+ cells in BALF were significantly higher than those in asthma and CB (P <0. 01 ). In CB,the ratio of neutrophils in BALF was significantly higher than that in asthma and HP (P <0.01 ). Conclusion: Cytological examination of BALF is effective in differentiating asthma, CB and HP,and provides usful infomation about different pathogenetic processes of the three diseases.