支气管肺泡灌洗液细胞分类及CD4+/CD8+对间质性肺疾病的诊断价值

Diagnostic contribution of bronchoalveolar lavage fluid cellular analysis and CD4+/CD8+in interstitial lung disease

目的探讨支气管肺泡灌洗液细胞分类及T细胞亚群测定对间质性肺疾病的诊断价值。方法选取我院收治的间质性肺疾病患者59例,行支气管肺泡灌洗及经支气管肺活检,测定灌洗液细胞分类及T细胞亚群CD4^+/CD8^+。结果59例患者最终明确诊断52例,其中结节病16例,特发性肺间质纤维化(IPF)5例,非特异性间质性肺炎(NSIP)10例,隐源性机化性肺炎(COP)11例,外源性过敏性肺炎(HP)2例,嗜酸性粒细胞肺炎(EP)2例。肺结核3例,血管炎1例。EP患者BALF嗜酸性粒细胞(EOS)大于25%;HP患者淋巴细胞比例高达70%;NSIP和结节病患者BALF中淋巴细胞比例增高,分别为34.0±19.56%和27.50±18.53%;结节病患者T细胞亚群CD4^+/CD8^+升高为5.64±3.90,而COP中降低为0.95±0.53。结论BALF细胞分类及T细胞亚群CD4^+/CD8^+测定有助于间质性肺疾病的鉴别诊断。

Objective To investigate the diagnostic contribution of bronchoalveolar lavage fluid (BALF) cellular analysis and T cell subsets CD4^+/CD8^+ in interstitial lung disease.Methods A total of 59 patients with interstitial lung disease were enrolled in this study.Bronchoalveolar lavage (BAL) and transbronchial lung biopsy were performed to test the lavage fluid cellular analyses and T cell CD4^+/CD8^+.Results A total of 52 patients were diagnosed in 59 cases,including 16 cases of sarcoidosis,5 cases of idiopathic pulmonary interstitial fibrosis (IPF),10 cases of non-specific interstitial pneumonia (NSIP),11 cases of cryptogenic organizing pneumonia (COP),2 cases of hypersensitivity pneumonia (HP) and 2 cases of eosinophilic pneumonia (EP).There were 3 cases of pulmonary tuberculosis and 1 case of vasculitis.The eosinophils (EOS) in BALF were more than 25% in EP patients and the lymphocyte ratio in HP patients was about 70%.The study showed lymphocytes in BALF were 34.0±19.56% and 27.50±18.53% in NSIP and sarcoidosis patients respectively.The CD4^+/CD8^+ of T cell subsets increased in patients with sarcoidosis (5.64±3.90) while decreased in COP (0.95±0.53).Conclusion BALF cellular analysis and T cell subset CD4^+/CD8^+ determination are helpful for the differential diagnosis of interstitial lung disease.