间质性肺疾病支气管肺泡灌洗液内皮素的检测及意义

Detection of ET levels in BALF of ILD patients and their clinical significance

目的探讨内皮素（ＥＴ）对肺纤维化发生发展作用及其在诊断中的价值。方法利用放射免疫直接测定法，检测１０例肺结节病和８例特发性肺纤维化（ＩＰＦ）患者外周血和支气管肺泡灌洗液（ＢＡＬＦ）中内皮素的含量，并与８例健康非吸烟者对照。结果肺结节病和ＩＰＦ患者血浆和ＢＡＬＦ中ＥＴ的含量分别为６２．１４±２９．２２，１７．４０±２．４１ｎｇ／Ｌ，和７６．９２±２１．９０，１０．４０±３．１３ｎｇ／Ｌ，均明显高于正常对照组２０．０８±８．３７，４．０４±０．５５ｎｇ／Ｌ，Ｐ＜０．０１；研究组ＢＡＬＦ中ＥＴ与ＰａＯ２呈负相关（ｒ＝－０．５３８Ｐ＜０．０１）；ＢＡＬＦ中ＥＴ水平与细胞总数呈正相关（ｒ＝０．６４９Ｐ＜０．０１），结节病中ＥＴ水平与淋巴细胞和ＩＰＦ中ＥＴ水平与中性粒细胞有明显正相关（ｒ＝０．７１２Ｐ＜０．０１，ｒ＝０．８１３Ｐ＜０．０１）。结论ＥＴ在肺结节病和ＩＰＦ发生发展中起重要的作用，并可做为判断疾病活动性的一项有用指标，为诊断提供一定的依据。

Objective To explore the role of the Endothelin (ET) in the development of interstitial lung diseases (ILD) and its signifi-cance in the diagnosis. Methods The ET level in the plasma and and Bronchial Alveolar Lavage Fluid (BALF) from 10 patients with sar-coidosis, 8 with idiopathic pulmonary fibrosis (IPF) and 8 normal non-smokers was determined using the radio-immunoassay. Results TheET level in the plasma BALF in the patients with sarcoidosis (62.14±29.22 and 17.40±2.4lng/L) and that in the IPF (76.92±71.90 and 10.40±3.13ng/L) were higher than that in 8 control normal subjects (20.08±8.37 and 4.04±0.55ng/L) p<0.01. The level of ET in the BALFwas negatively correlated With PaO_2 (r=-0.538,p<0.01). The level of ET in positively correlated with total cells in BALF (r=0.649 P<0.01).The level of ET in the BALF of the saroidosis was positively correlated with the percirentage of lymphocyte (r=0.712 p<0.01) and that inpatients with IPF was positively correlated with the percentage of neutrophil (r=0.813 p<0.01). Conclusion It was indicated that ET mightplay an important role in development of ILD. The level of ET can act as the markers of activity of the diseases and provide the basis onthe diagonsis.