Behera D, Kaur Simran, Sathyanarayana G, Majumdar S
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India.
J Assoc Physicians India. 2002 Nov;50:1409-12.
Alterations in surface-active material may contribute to the pathogenesis of idiopathic pulmonary fibrosis both by increasing the elastic recoil due to surface forces and by promoting alveolar collapse. This study intends to evaluate the surfactant protein-A levels in bronchoalveolar lavage in patients of idiopathic pulmonary fibrosis.
Ten patients of idiopathic pulmonary fibrosis (IPF) of either sex were taken up for estimation of surfactant protein-A (SP-A) levels in bronchoalveolar lavage. The final diagnosis of IPF was based on histopathology and high resolution CT. Ten controls were taken out of which five patients were histopathologically proven cases of sarcoidosis and five patients with normal chest X-ray and CT scan. History, physical examination and routine investigations were done to rule out any concomitant illness.
Age range of patients varied from 37-65 years (mean +/- SD of 50.65 +/- 9.05) and controls 30-62 years (42.50 +/- 9.95). Fiberoptic bronchoscopy and bronchoalveolar lavage was carried out and fluid aspirated was studied for surfactant protein-A. The level of surfactant protein-A recovered was lower in patients with idiopathic pulmonary fibrosis in comparison to control group p < 0.01 (1.86 +/- 1.26 and 5.76 +/- 2.0 microg/ml respectively). The levels of surfactant protein-A also revealed that the level decreased with derangement of pulmonary function.
The study thus showed that the level of surfactant protein A is reduced in patients with idiopathic pulmonary fibrosis. It is likely that they have a significant role in pathogenesis of idiopathic pulmonary fibrosis and its progression. Surfactant-A may have important therapeutic implications. Further studies are required for a definite answer.
表面活性物质的改变可能通过增加表面力导致的弹性回缩以及促进肺泡塌陷，在特发性肺纤维化的发病机制中发挥作用。本研究旨在评估特发性肺纤维化患者支气管肺泡灌洗中表面活性蛋白A的水平。
选取10例特发性肺纤维化（IPF）患者，男女不限，用于评估支气管肺泡灌洗中表面活性蛋白A（SP-A）的水平。IPF的最终诊断基于组织病理学和高分辨率CT。选取10例对照，其中5例经组织病理学证实为结节病，5例胸部X线和CT扫描正常。进行病史、体格检查和常规检查以排除任何合并疾病。
患者年龄范围为37 - 65岁（平均±标准差为50.65±9.05），对照为30 - 62岁（42.50±9.95）。进行了纤维支气管镜检查和支气管肺泡灌洗，并对吸出的液体进行表面活性蛋白A研究。与对照组相比，特发性肺纤维化患者回收的表面活性蛋白A水平较低，p < 0.01（分别为1.86±1.26和5.76±2.0微克/毫升）。表面活性蛋白A水平还显示，其水平随肺功能紊乱而降低。
本研究表明，特发性肺纤维化患者的表面活性蛋白A水平降低。它们可能在特发性肺纤维化的发病机制及其进展中起重要作用。表面活性蛋白A可能具有重要的治疗意义。需要进一步研究以获得确切答案。
