Metersky M L, Harrell J H, Moser K M
Division of Pulmonary and Critical Care Medicine, University of California, San Diego Medical Center 92103.
Chest. 1992 Mar;101(3):680-3. doi: 10.1378/chest.101.3.680.
While bronchoalveolar lavage has been shown to be more sensitive than brush biopsy (BB) for the diagnosis of Pneumocystis carinii pneumonia in AIDS patients, some have reported that BB occasionally is positive in spite of a negative BAL. Many bronchoscopists, therefore, continue to perform routine BB when doing bronchoscopy on AIDS patients. We performed a retrospective study of all fiberoptic bronchoscopies done on human immunodeficiency virus-infected patients over a one-year period at our institution to determine if the use of BB added to the diagnostic yield of bronchoscopy over that of BAL alone. Of 84 bronchoscopies in which BB was performed in addition to BAL, BB yielded no diagnoses that were not obtained by BAL. Brush biopsy added approximately $400 to the cost of bronchoscopy. We conclude that BB should not be routinely done when performing bronchoscopy on HIV-infected patients.
虽然支气管肺泡灌洗已被证明在诊断艾滋病患者的卡氏肺孢子虫肺炎方面比刷检活检（BB）更敏感，但一些人报告称，尽管支气管肺泡灌洗结果为阴性，刷检活检偶尔也呈阳性。因此，许多支气管镜检查医师在对艾滋病患者进行支气管镜检查时仍继续进行常规刷检活检。我们对本机构在一年时间里对感染人类免疫缺陷病毒的患者进行的所有纤维支气管镜检查进行了回顾性研究，以确定刷检活检的应用是否能提高支气管镜检查的诊断率，使其高于单纯支气管肺泡灌洗的诊断率。在84例除支气管肺泡灌洗外还进行了刷检活检的支气管镜检查中，刷检活检没有得出支气管肺泡灌洗未获得的诊断结果。刷检活检使支气管镜检查的费用增加了约400美元。我们得出结论，在对感染HIV的患者进行支气管镜检查时，不应常规进行刷检活检。
