患有炎症性和非炎症性肺部疾病儿童的支气管肺泡灌洗术
Bronchoalveolar lavage in children with inflammatory and non inflammatory lung disease.
作者信息
Gidaris D, Kanakoudi-Tsakalidou F, Papakosta D, Tzimouli V, Taparkou A, Ventouri M, Tsanakas I
出版信息
Hippokratia. 2010 Apr;14(2):109-14.
BACKGROUND
Bronchoalveolar lavage (BAL) is a useful bronchoscopic technique. Studies in "normal" children are limited.
AIM
To provide data on BAL reference values from Greek children and compare BAL cellular and noncellular components in children with inflammatory and non-inflammatory lung diseases.
METHODS
Seventy two children, aged 2.5 months to 16 years, underwent diagnostic bronchoscopy and BAL. Patients were divided in two groups whether lung inflammation was absent or present. Differential cytology, flow cytometry for lymphocyte subsets and cytokine and chemokine measurements were performed on BAL fluid.
RESULTS
Alveolar macrophages were the predominant cellular population in normal children. Patients with inflammatory pneumonopathies had significantly more neutrophils. There was no difference in lymphocyte subpopulations. Values of CD4+/CD8+ ratio in BAL was similar to that reported in adults. Levels of IL-8 and TNF- alpha were significantly higher in children with inflammatory lung diseases.
CONCLUSION
This study provides the first data on BAL of "normal" Greek children. BAL from patients with pulmonary inflammation was characterised by neutrophilia. Finally, we propose that measurement of IL-8 and TNF-a levels in BAL could help in early identification of inflammation in the tracheobronchial tree.
背景
支气管肺泡灌洗（BAL）是一种有用的支气管镜检查技术。关于“正常”儿童的研究有限。
目的
提供希腊儿童BAL参考值的数据，并比较患有炎症性和非炎症性肺部疾病儿童的BAL细胞和非细胞成分。
方法
72名年龄在2.5个月至16岁之间的儿童接受了诊断性支气管镜检查和BAL。根据是否存在肺部炎症将患者分为两组。对BAL液进行细胞分类学、淋巴细胞亚群的流式细胞术以及细胞因子和趋化因子测量。
结果
肺泡巨噬细胞是正常儿童中主要的细胞群体。患有炎症性肺病的患者中性粒细胞明显更多。淋巴细胞亚群没有差异。BAL中CD4+/CD8+比值与成人报道的相似。炎症性肺病儿童的IL-8和TNF-α水平明显更高。
结论
本研究提供了关于“正常”希腊儿童BAL的首批数据。肺部炎症患者的BAL以中性粒细胞增多为特征。最后，我们建议测量BAL中IL-8和TNF-α水平有助于早期识别气管支气管树中的炎症。
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