支气管肺泡灌洗液淋巴细胞亚群对肺部病变的诊断意义

The Diagnostic Value of Lymphocyte Subsets in Bronchoalveolar Lavage Fluid for Lung Diseases

目的比较肺部感染,肺恶性肿瘤及间质性肺病患者支气管肺泡灌洗液细胞计数及淋巴细胞亚群的表达水平,评价其临床意义。方法选取2017年5月至2019年12月收治的98例患者,其中肺部感染56例,肺恶性肿瘤18例,间质性肺疾病24例,检测肺泡灌洗液计数及淋巴细胞亚群水平。结果肺部感染组中性粒细胞百分比及总NK细胞百分比显著升高,巨噬细胞百分比显著减少,与其他两组比较差异有统计学意义。肺恶性肿瘤组CD3+T淋巴细胞、CD4+T淋巴细胞及CD4+/CD8+T淋巴细胞比值显著减低,与感染组相比,差异有统计学意义(P<0.05)。间质性肺病组CD8+T淋巴细胞及抑制性T淋巴细胞(CD8+CD28-)显著升高,与其他两组相比,差异有统计学意义(P<0.05)。结论检测支气管肺泡灌洗液细胞分类及淋巴细胞亚群水平,对于鉴别肺部病变、评估免疫功能及预后有一定的临床价值。

Objective To compare the cell count and lymphocyte subsets expressions in bronchoalveolar lavage fluid(BALF)of patients with pulmonary infection,lung cancer and interstitial lung disease,and to evaluate its clinical significance.Methods 98 patients from May,2017 to December,2019 were selected for the study,including 56 cases of pulmonary infection,18 cases of lung malignant tumor and 24 cases of interstitial lung disease.Results In the pulmonary infection group,the percentage of neutrophils and total NK cells were significantly increased,while the percentage of macrophages was significantly decreased,and the difference was statistically significant when compared with the other two groups.In the lung cancer group,CD3+T lymphocytes,CD4+T lymphocytes and CD4+/CD8+T lymphocytes were significantly lower than those in the infection group(P<0.05).In the interstitial lung disease group,CD8+T lymphocytes and inhibitory T lymphocytes(CD8+CD28-)were significantly increased,when compared with the other two groups,the difference was statistically significant(P<0.05).Conclusion Detection of cell classification and lymphocyte subsets in bronchoalveolar lavage fluid has certain clinical values for differentiating lung diseases,evaluating immune function and prognosis.