127例儿童支气管肺泡灌洗液细胞类型特点及临床意义分析  

The characteristic of cell profile and their clinical significance of bronchoalveolar lavage fluid of 127 pediatric patients

作　　者：朱春梅[1] 钱婧[1] 曹玲[1] 张奕[1] 郑宝英[1] 戴淑芝[2] 姚海兰[3] 

机构地区：[1]首都儿科研究所附属儿童医院呼吸科,北京100020 [2]首都儿科研究所附属儿童医院检验科,北京100020 [3]首都儿科研究所附属儿童医院分子免疫室,北京100020

出　　处：《中国医刊》2016年第11期60-63,共4页Chinese Journal of Medicine

摘　　要：目的分析支气管肺泡灌洗液(bronchoalvelar lavage fluid,BALF)细胞成分变化与相关肺部疾病的关系,探讨其在肺部疾病诊治中的意义。方法选取2015年3月至2016年3月本院呼吸内科住院127例呼吸系统疾病患儿,所有病例分成3组,分别为肺炎组65例,哮喘组45例,其他组17例(支气管异物13例,肺不张1例,肺泡蛋白沉积症1例,弥漫性肺病1例,咯血待查1例),所有病例均行支气管肺泡灌洗术收集BALF,进一步行细胞学分类检测,分析BALF细胞成分变化。结果哮喘组、肺炎组与其他组白细胞总数差异有显著性(P<0.05)。肺炎组与其他组分叶核细胞比例差异有显著性(P<0.05),肺炎组分叶核细胞比例明显高于其他组。将所有标本进行二次分组,感染组为肺炎组,共65例,非感染组包括哮喘组及其他组病例,共62例,结果显示两组间白细胞总数、分叶核细胞比例、巨噬细胞比例比较,差异有显著性(P<0.05),其中白细胞总数、分叶核细胞比例感染组明显高于非感染组,而巨噬细胞比例在非感染组明显高于感染组,差异有显著性。结论肺炎患儿支气管肺泡灌洗液以白细胞总数、分叶核细胞比例增高为其特征性改变。巨噬细胞比例升高可为哮喘、其他非感染性疾病和感染性疾病的鉴别提供参考依据。Objective To find out the cell components in bronchoalvelar lavage fluid（BALF） changes associated with lung disease,and to explore its significance in diagnosis and treatment of pulmonary diseases.Method All the cases divided into three groups,which were pneumonia group（65 cases）,asthma group（45 cases）,other group 17 cases（13 cases of foreign body in bronchus,1 case of atelectasis,1 case of pulmonary alveolar proteinase＇s,diffuse lung disease in 1 case,1 cases of hemoptysis of unknown origin）.All cases underwent bronchoalveolar lavage were collected by bronchoalveolar lavage fluid further cytological classification and detection.Result There was significant difference in the total number of white blood cells,the percentage of nuclear cells,and the proportion of macrophages in the asthma group,pneumonia group and other groups（P〈0.05）.The total number of white blood cells in asthma group,pneumonia group and other groups were significantly different（P〈0.05）,the total white blood cell count was significantly increased in asthma group and pneumonia group.The pneumonia group and other groups divided into the proportion of polymorphonuclear cells had significant difference,the pneumonia group polymorphonuclear cells was significantly higher than that of the other groups（P〈0.05）,macrophages in non infectious diseases than infectious diseases have significant and non infection diseases macrophage ratio was significantly higher than that of the infected group.Conclusion The total number of white blood cells and the percentage of nuclear cells in the bronchoalveolar lavage fluid of children with pneumonia were characterized.The increase of macrophages can provide a reference in asthma,other non infectious diseases and infectious diseases.

关 键 词：支气管肺泡灌洗液 巨噬细胞 哮喘 肺炎 儿童 

分 类 号：R725.6[医药卫生—儿科]