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[系统性硬化症和类风湿关节炎患者支气管肺泡灌洗与肺功能的相关性]

[Correlation between bronchoalveolar lavage and lung function in patients with systemic sclerosis and rheumatoid arthritis].

作者信息

Pejcić Tatjana, Stanković Ivana, Rancić Milan, Djordjević Ivanka, Ristić Lidija, Vojinović Jelena

出版信息

Srp Arh Celok Lek. 2005 Dec;133 Suppl 2:129-33.

PMID:16535997
Abstract

Fibrous alveolitis (FA), or diffuse interstitial fibrosis, is used as a term for diseases in patients suffering from some kind of systemic connective tissue (SCT) disorder and lung fibrosis. FA is not unusual in clinical practice in patients with SS and rheumatoid arthritis (RA) and can be found in the definitive fibrosis phase of the disease; the early detection of FA is of great importance. The aim of this study was to determine whether there was a correlation between certain lung function parameters and cellular components of BAL in patients with SS and RA. Lung function (LF) and BAL examination was carried out in all 20 SS patients and 38 RA patients. LF was evaluated via spirometry, flow volume curves, the lung transfer factor for carbon monoxide (DLco), and the coefficient of transfer factor (K/DLco), as well as body plethysmography and blood gas analysis. A differential number of cells were taken in all BAL samples. Normal cellular components of lavage were found in 19 patients (50%). Ly-alveolitis was found in 10 patients (4 with SS and 6 with RA) (26%), and N-alveolitis in 9 patients (8 with SS and 1 with RA) (23.7%). An increased percentage of CD8+T lymphocytes in relation to CD4+T lymphocytes, and a decreased level of CD4+/CD8+ was found through BAL. Restrictive ventilation disorder was discovered in 6 patients (15.7%), TLC values were reduced in 6 patients (15.7%), and K/DLco was decreased in 5 patients. DLco was normal in 20 patients (53%) and reduced in 18 patients (47%). We discovered a significant correlation between DLco and cellular components (neutrophile or lymphocyte) present in BAL, but there was no significant correlation between other lung function parameters. Analysis of BAL and DLco examination can be considered to be suitable parameters of interstitial lung changes in SS and RA patients.

摘要

纤维性肺泡炎(FA),即弥漫性间质性纤维化,用于描述患有某种系统性结缔组织(SCT)疾病和肺纤维化患者的疾病。FA在干燥综合征(SS)和类风湿关节炎(RA)患者的临床实践中并不罕见,可在疾病的明确纤维化阶段发现;FA的早期检测非常重要。本研究的目的是确定SS和RA患者的某些肺功能参数与支气管肺泡灌洗(BAL)细胞成分之间是否存在相关性。对所有20例SS患者和38例RA患者进行了肺功能(LF)和BAL检查。通过肺量计、流量容积曲线、一氧化碳肺转移因子(DLco)、转移因子系数(K/DLco)以及体容积描记法和血气分析来评估LF。对所有BAL样本进行了细胞计数。19例患者(50%)的灌洗细胞成分正常。发现10例患者(4例SS患者和6例RA患者)存在淋巴细胞性肺泡炎(26%),9例患者(8例SS患者和1例RA患者)存在中性粒细胞性肺泡炎(23.7%)。通过BAL发现CD8 + T淋巴细胞相对于CD4 + T淋巴细胞的百分比增加,CD4 + /CD8 +水平降低。6例患者(15.7%)发现限制性通气障碍,6例患者(15.7%)的肺总量(TLC)值降低,5例患者的K/DLco降低。20例患者(53%)的DLco正常,18例患者(47%)的DLco降低。我们发现DLco与BAL中存在的细胞成分(中性粒细胞或淋巴细胞)之间存在显著相关性,但其他肺功能参数之间无显著相关性。BAL分析和DLco检查可被视为SS和RA患者间质性肺改变的合适参数。

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