Zielonka T M, Wałajtys-Rode E, Jasińska R, Chazan R, Droszcz W
Kliniki Pneumonologii, Akademii Medycznej w Warszawie.
Przegl Lek. 1998;55(12):654-8.
Phospholipids found in the alveolar space come from the surfactant which is produced by type II pneumocytes and whose surplus is eliminated from lungs by macrophages. In 188 patients with interstitial pulmonary diseases bronchoalveolar lavage was performed. Phospholipids from the supernatant of BALF were extracted using of Folch method and their concentration was measured colorimetrically assaying inorganic phosphorus after prior mineralization by Fiske-Subbarov method. The persons were divided into 7 groups: active sarcoidosis, inactive sarcoidosis, avian fancier's lung in the period of contact with the antigen, and after stopping the contact with the antigen, advanced idiopathic pulmonary fibrosis, moderate idiopathic pulmonary fibrosis, and a control group of healthy persons. Apart from that, the patients were divided into untreated and treated with corticosteroids. In every group of patients we have noticed increased concentration and total amount of phospholipids in BALF. Particularly distinct increase of the total number of phospholipids in BALF in pulmonary fibrosis was observed. However, this parameter does not permit to estimate disease activity in interstitial lung disease. Corticotherapy increases phospholipids concentration in BALF in patients with idiopathic pulmonary fibrosis and avian fancier's lung but decreases in sarcoidosis patients.
肺泡腔内发现的磷脂来自表面活性剂,该表面活性剂由II型肺细胞产生,其多余部分由巨噬细胞从肺中清除。对188例间质性肺疾病患者进行了支气管肺泡灌洗。采用Folch法从支气管肺泡灌洗(BALF)上清液中提取磷脂,并在通过Fiske-Subbarov法进行预矿化后,采用比色法测定无机磷来测量其浓度。将这些人分为7组:活动期结节病、非活动期结节病、接触抗原期间的养鸟人肺以及停止接触抗原后、晚期特发性肺纤维化、中度特发性肺纤维化和健康人对照组。除此之外,将患者分为未治疗组和接受皮质类固醇治疗组。在每组患者中,我们都注意到BALF中磷脂浓度和总量增加。在肺纤维化患者中观察到BALF中磷脂总数尤其明显增加。然而,该参数无法评估间质性肺病的疾病活动度。皮质激素疗法可增加特发性肺纤维化和养鸟人肺患者BALF中的磷脂浓度,但在结节病患者中则降低。