摘要
目的 :探讨弥漫性肺疾病支气管肺泡灌洗液 (BALF)检查的临床意义。方法 :71例X线胸片或高分辨CT示弥漫性肺疾病者进行支气管肺泡灌洗 (BAL) ,与 12例胸片和肺功能均正常者作对照。BALF进行细胞计数、分类 ,查找癌细胞、结核菌 ,部分标本测定T淋巴细胞亚群。结果 :结核组BALF病因诊断率 46 .7% ,高于经支气管肺活检 (TBLB ,16 .7% )和支刷(33.5 % ) ;肺癌组BALF与TBLB确诊率相同 (46 .2 % ) ,高于支刷 (2 3.1% ) ,BALF细胞学显示 :(1)肺癌组呈Lyc %下降 ,Neu %增高 ,CD4+ %下降 ,CD8+ %增高 ,CD4+ /CD8+ 比值 <1;(2 )致纤维化肺泡炎 (IPF)BALF呈中性粒细胞肺泡炎 (Neu达2 4.89± 2 1.42 % ) ;(3)过敏性肺泡炎 (HP)呈淋巴细胞肺泡炎〔Lyc达 (19.40± 3.2 4) %〕 ;(4)结缔组织病合并肺泡炎 (CP)BALFLyc%和Neu %均增高 (P <0 .0 1)。结论 :BALF检查对弥漫肺的诊断、鉴别诊断、临床分型、判断预后及探明肺局部免疫病理生理变化均有帮助。
?Objective:To investigate the clinical significance of bronchoalveolar lavage fluid(BALF) examination in diffuse pulmonary disease.Methods:Examination of BALF was carried out in 71 patients with diffuse pulmonary disease based on chest roentgenography or HRCT scanning and 12 normal subjects served as controls.The examination of BALF included total cell count,differential count,malignant cells,tuberculous bacilli as well as T lymphocyte subsets.Results:In etiological examination,the diagnostic rate of pulmonary tuberculosis in BALF was 46.7%,higher than that in transbronchial lung biopsy(TBLB,16.7%) and bronchial brush(BB, 33.5 %).The diagnostic rate of lung cancer in BAL(46.2%) was similar to that in TBLB(46.2%) and higher than that in BB(23.1%).Cytologic analysis of BALF showed that:(1)In lung cancer group,neutrophil percentage increased,lymphocyte percentage decreased with lower CD4 +% and higher CD8 +%,ratio of CD4 +% to CD8 +% is less than one;(2)In idiopathic pulmonary fibrosis group,neutrophil percentage accounted for(24.89±21.42)%,implied neutrophilic alveolitis;(3)In hypersensitivity pneumonia group,lymphocyte percentage reached(19.40±3.24)%,as the character of lymphocyte alveolitis;(4)In the group of connective tissue disease associated with pneumonia,both neutrophil and lymphocyte elevated significantly( P <0.01).Conclusions:BALF examination is helpful not only to make differential diagnosis of diffuse pulmonary disease but also to estimate its prognosis as well as the local immunological and pathophysiological changes.
出处
《蚌埠医学院学报》
CAS
2000年第1期26-28,共3页
Journal of Bengbu Medical College
关键词
肺疾病
支气管肺泡洗出液/分析
pulmonary disease
bronchoalveolar lavage fluid/analysis