Moreira Valeria Barbosa, Ferreira Angela Santos, Soares Porphirio José, Gabetto José Manoel, Rodrigues Cristóvão Clemente
Serviço de Endoscopia Respiratória, Hospital Universitário Antônio Pedro (UFF), Rio de Janeiro, Brazil.
Rev Port Pneumol. 2005 Sep-Oct;11(5):457-75. doi: 10.1016/s0873-2159(15)30522-5.
Silicosis is a disease caused by inhalation and deposition of crystalline silica that produces a fibrous tissue reaction. Bronchoalveolar lavage is a noninvasive technique that allows identifying particles, thus characterizing exposure to mineral dust. The aim of this work was to study bronchoalveolar lavage as a mean of estimating the amount of alveolar particles in different forms of silicosis. Bronchoalveolar lavage was carried out in 27 silicotic patients with simple (n = 12), complicated (n = 13), and acute (n = 2) forms of the disease and 7 healthy individuals as a control group. Macrophages were scored enumerating the percentage of cells with particles by polarizing light microscopy. Silicotic patients showed a marked increase in BAL cell particles compared to control population, however, relating simple to complicated silicosis, no significant difference was observed. In acute silicotic patients with massive silica dust exposure, more than 70% of BAL alveolar macrophages contained dust particles. When duration of exposure and retirement from work were evaluated, an inverse correlation between duration of exposure and the amount of alveolar dust, and a tendency to a smaller involvement on macrophages with the greater period of retirement from work were observed. These results suggest that particle analysis in BAL may be important in order to establish the nature and intensity of exposure.
矽肺是一种因吸入并沉积结晶二氧化硅而引发的疾病，会产生纤维组织反应。支气管肺泡灌洗是一种非侵入性技术，可用于识别颗粒，从而确定对矿物粉尘的接触情况。这项工作的目的是研究支气管肺泡灌洗作为评估不同形式矽肺中肺泡颗粒数量的一种手段。对27名患有单纯型（n = 12）、复杂型（n = 13）和急性型（n = 2）矽肺的患者以及7名健康个体作为对照组进行了支气管肺泡灌洗。通过偏光显微镜对巨噬细胞进行评分，计算含有颗粒的细胞百分比。与对照组相比，矽肺患者的支气管肺泡灌洗细胞颗粒明显增加，然而，在单纯型矽肺和复杂型矽肺之间未观察到显著差异。在大量接触二氧化硅粉尘的急性矽肺患者中，超过70%的支气管肺泡灌洗肺泡巨噬细胞含有尘粒。当评估接触时间和离岗时间时，观察到接触时间与肺泡粉尘量之间呈负相关，并且离岗时间越长，巨噬细胞受累的趋势越小。这些结果表明，支气管肺泡灌洗中的颗粒分析对于确定接触的性质和强度可能很重要。
