结节病患者肺功能与支气管肺泡灌洗液细胞学关系的研究

Relationship between pulmonary function and bronchoaiveolar lavage fluid cytology in patients with sarcoidosis

目的探讨结节病患者不同影像分期之间肺功能指标、支气管肺泡灌洗液细胞学的改变以及两者的相关性。方法同顺性调查71例结节病患者肺功能以及支气管肺泡灌洗液榆查的资料。结果在结节病患者不同影像分期之间肺功能指标用力肺活量（FVC）占预计值％、第1秒用力呼气容积（FEV1）占预计值％、肺总量（TLC）占预计值％以及肺一氧化碳弥散量（DLCO）占预计傅％的差异有统计学意义（P值均〈0．05），支气管肺泡灌洗液中淋巴细胞百分比的差异有统计学意义（P〈0．05）；支气管肺泡灌洗液中巾性粒细胞百分比与肺功能指标中FVC占预计值％、FEV1占预计值％、肺活量（VC）占预计值％、TLC占预计值％以及DLCO占预计值％等呈负相关（P〈0．05或，P〈0．01）；嗜酸粒细胞百分比与FVC占预计值％、VC占预计值％呈负相关（P〈0．05或P〈0．01）；CD4T细胞百分比与FVC占预计值％、VC占预计值％、TLC占预计值％以及DLCO占预计值％呈正相关（P〈0．05）；CD8T细胞百分比与TLC占预计值％呈负相关（P〈0．05）。结论结节病患者不同影像分期之间肺功能指标、肺泡灌洗液细胞学的变化以及它们之间可能存存的相关性．可埘结节病患者动态观察以及临床预后提供判断依据。

Objective To study the relationship between parameters of pulmonary function and bronchoalveolar lavagc fluid （BAI.F） cytology in different stages of sarcoidosis. Methods The data of the parameters of pulmonary function and BAI.F in 71 patients with sarcoidosis were retrospectively analyzed. Results There was statistical significance on forced vital capacity （FVC） pred%, forced expiratory volume in the first second （FEVI） pred% ,total lung capacity （TI.C） pred% ,diffusing capacily of lung for carbon monoxide （DI.CO） pred%,and lymphocyte percent in BAI.F in different stages of sarcoidosis （all P 〈 0.05）. The percentage of neutrophil in BAI.F was negatively correlated with FVC pred%, FEV1 pred＇,vital capacity （VC） pred%, TLC pred% and DLCO pred% （ P〈0.05 orP〈0.01）. The percentage of eosinophils in BALF was negatively correlated with FVC pred%. VC pred% （ P〈0.05 or P 〈0.01）. The percentage of CD4 T cells in BAI.F was positively correlated with FVC pred＇, VC pred%,TLC pred% and DI.CO pred%（ P 〈0.05）. The percentage of CD8 T cells in BALF was nagatively correlated with TLC pred% （ P 〈 0.05）. Conclusions The changes of the parameters of pulmonary function and cytology in BALF in different stages of sarcoidosis and the relationship of them may provide basis for the dynamical observation and clinical prognosis of patients with sarcoidosis.