Baldwin D R, Wise R, Andrews J M, Honeybourne D
Department of Thoracic Medicine, Dudley Road Hospital, Birmingham.
Thorax. 1991 Sep;46(9):658-62. doi: 10.1136/thx.46.9.658.
A new technique ("microlavage") was used to determine the volume of epithelial lining fluid recovered by bronchoalveolar lavage. A standard bronchial brush tube is used to lavage a peripheral lung subsegment rapidly with 20 ml of normal saline and the concentrations of urea and total protein are measured in the aspirated fluid. Using a very short dwell time for fluid (less than 20 seconds), this technique allows the urea dilution method to be used to quantify the epithelial lining fluid protein concentration, which is then used as an endogenous marker of the epithelial lining fluid in conventional bronchoalveolar lavage fluid. The reproducibility of the calculation of the concentration of the lining fluid protein was assessed in 10 patients by performing the method in three separate lung subsegments. The mean coefficient of variation of the urea to protein ratio was 9.0%. A comparison of microlavage and conventional lavage was made in a further 28 patients. The differential cell counts were similar by the two methods, suggesting that similar epithelial lining fluid was sampled. The application of the microlavage technique to the calculation of epithelial lining fluid volume gave a lower value than the urea dilution method in association with conventional lavage. Microlavage should provide more accurate quantification of epithelial lining fluid volume and could be used in conjunction with conventional lavage, which is still required for an adequate harvest of alveolar cells.
一种新技术（“微量灌洗”）被用于测定支气管肺泡灌洗回收的上皮衬液体积。使用标准支气管刷管，用20毫升生理盐水快速灌洗外周肺亚段，并测量吸出液中尿素和总蛋白的浓度。由于液体停留时间非常短（少于20秒），该技术可采用尿素稀释法来定量上皮衬液蛋白浓度，然后将其用作传统支气管肺泡灌洗液体中上皮衬液的内源性标志物。通过在10名患者的三个不同肺亚段中进行该方法，评估了衬液蛋白浓度计算的可重复性。尿素与蛋白比值的平均变异系数为9.0%。在另外28名患者中对微量灌洗和传统灌洗进行了比较。两种方法的细胞分类计数相似，表明采集到了相似的上皮衬液。与传统灌洗联合使用尿素稀释法相比，将微量灌洗技术应用于上皮衬液体积计算得出的值更低。微量灌洗应能更准确地定量上皮衬液体积，并且可与传统灌洗联合使用，而传统灌洗对于充分采集肺泡细胞仍然是必需的。
