3种弥漫性肺病支气管肺泡灌洗液细胞免疫活性研究  

Cellular immunity study of three bronchoalveolar lavage fluids for diffuse lung disease

作　　者：赵丽华[1] 陈谨[1] 崔建英[1] 蔡欣[1] 叶艳平[1] 何耀红[1] 

机构地区：[1]首都医科大学附属复兴医院呼吸科,北京100038

出　　处：《中国内镜杂志》2013年第8期801-805,共5页China Journal of Endoscopy

基　　金：北京市西城区人才培养专项(No.200900039)

摘　　要：目的探讨在影像表现难以鉴别的特发性肺纤维化、肺结节病和肺癌性淋巴管炎三者的支气管肺泡灌洗液（BALF）中细胞类别和其中T淋巴细胞免疫活性对于临床诊断及鉴别诊断的意义。方法选取2005年1月~2013年2月住院且诊断为特发性肺纤维化（IPF,32例）、肺结节病（Sar,21例）和肺癌性淋巴管炎（PLC,22例）的患者,对比3类疾病患者的临床症状、HRCT主要特征及肺功能情况,并行支气管镜肺泡灌洗（BAL）,检测BALF中细胞分类及T淋巴细胞亚群的水平。结果 Sar、IPF和PLC三者的中IPF表现的限制性通气功能及弥散功能显著降低。BALF检测,细胞总数上,Sar高于PLC;L%是IPF低于Sar及PLC,IPF在N%和E%上均高于其余两组。T淋巴细胞亚群中,CD3＋%在3组之间差异无显著性;CD4＋%、CD4＋/CD8＋比值在3组间由高到低为Sar、IPF和PLC;CD8＋%正好反之。结论通过BALF检测细胞分类及T淋巴细胞亚群水平对于Sar、IPF、PLC三者的鉴别诊断有一定的帮助。【Objective】To investigate the brochoalveolar lavage cell differentiation and T cell subpopulations in Sar IPF and PLC whose CT image are similar and explore their significance for diagnosis and differential diagnosis.【Methods】75 patients admitted were collected from Jan.2005 to Feb.2013.Of 75 patients,21 were sarcoidosis,32 were IPF and 22 were PLC.The symptoms,HRCT and pulmonary function tests among Sar,IPF and PLC,and bronchoalveolar lavage were compared.And then,detected the brochoalveolar lavage cell differentials and T cell subpopulations.【Results】Restricted ventilation function and diffuse function of IPF decreased than others.Total cell count in BALF of Sar was higher than PLC;L% of IPF was lower than Sar and PLC while N% and E% were higher than them.About T cell subpopulations,CD3 ＋% had no significance among the three groups.CD4 ＋%,CD4 ＋/ CD8 ＋ratio from high to low were Sar,IPF and PLC,CD8 ＋% was on the contrary.【Conclusions】The results suggest the brochoalveolar lavage cell differentiation and T cell subpopulations have significance for diagnosis and differential diagnosis of Sar,IPF and PLC.

关 键 词：特发性肺纤维化 肺结节病 肺癌性淋巴管炎 支气管肺泡灌洗液 T淋巴细胞亚群 

分 类 号：R655.3[医药卫生—外科学]