支气管肺泡灌洗液分析在过敏性肺炎诊断中的作用

Role of bronchoalveolar lavage fluid analysis in the diagnosis of hypersensitivity pneumonitis

过敏性肺炎(HP)是一种反复吸入有机抗原导致的肉芽肿性肺部疾病。目前尚缺乏确诊HP的金标准,需综合抗原暴露史、临床症状、肺功能、胸部高分辨率CT (HRCT)、支气管肺泡灌洗液(BALF)分析结果和组织病理学资料,进行多学科讨论后诊断。淋巴细胞增多是HP患者的BALF细胞学分析的常见表现。BALF细胞学分析能为HP的诊断提供重要的支持依据,缩小鉴别诊断范围,使患者一定程度上避免外科肺活检。

Hypersensitivity pneumonitis is a group of granulomatous lung disease caused by repeated exposure and sensitization to a variety of organic antigens. Establishing a diagnosis of HP is challenging as no gold standard for diagnosis of HP is currently available. The diagnosis is based on integration of history, clinical manifestations, pulmonary function, high-resolution chest CT(HRCT), bronchoalveolar lavage fluid(BALF) analysis and histopathological features, which is a multidisciplinary diagnosis. The BALF cell profile in HP is characterized by a significant increase in the percentage of lymphocytes. BALF cellular analysis can provide additional supportive evidence of the diagnosis of HP, which narrows the differential diagnosis of HP and helps some patients avoid surgical lung biopsy.