Durand-Amat S, Zalcman G, Mazeron M C, Sarfati C, Beauvais B, Gerber F, Pérol Y, Hirsch A
Service de Pneumologie, Hôpital Saint-Louis, Paris, France.
Eur Respir J. 1990 Mar;3(3):282-7.
During a ten month period, 117 fibreoptic bronchoscopies and bronchoalveolar lavages (BAL) were performed in human immunodeficiency virus (HIV) infected patients suspected of having opportunistic pulmonary infections. The BAL were classified into 3 groups, according to clinical manifestations related to HIV infection at the time of fibreoptic bronchoscopy: pre-acquired immunodeficiency syndrome (AIDS) (n = 54), AIDS with Kaposi's sarcoma (n = 37), AIDS without Kaposi's sarcoma (n = 26). On chest X-ray, diffuse infiltrates were most common (54%), followed by normal X-rays (24%) and localized infiltrates (18%). Amongst the 117 BAL, 68 (58%) yielded at least one opportunistic agent. In 28 BAL performed for pulmonary signs or unexplained fever with normal chest X-rays, one or several opportunistic agents were isolated in 17 samples of BAL fluid. The most frequently identified opportunistic agents were Pneumocystis carinii (in 38% of BAL) and cytomegalovirus (35%); these were associated in 17% of BAL. There was no statistically significant difference in opportunistic agents among the 3 groups of BAL (pre-AIDS, AIDS with Kaposi's sarcoma, AIDS without Kaposi's sarcoma). In particular, cytomegalovirus was found in BAL with the same frequency in these 3 groups.
在为期十个月的时间里，对怀疑患有机会性肺部感染的人类免疫缺陷病毒（HIV）感染患者进行了117次纤维支气管镜检查和支气管肺泡灌洗（BAL）。根据纤维支气管镜检查时与HIV感染相关的临床表现，将BAL分为3组：艾滋病前期（n = 54）、伴有卡波西肉瘤的艾滋病（n = 37）、不伴有卡波西肉瘤的艾滋病（n = 26）。胸部X线检查显示，弥漫性浸润最为常见（54%），其次是X线正常（24%）和局限性浸润（18%）。在117次BAL中，68次（58%）至少检出一种机会性病原体。在因肺部症状或胸部X线正常的不明原因发热而进行的28次BAL中，17份BAL液样本中分离出一种或几种机会性病原体。最常鉴定出的机会性病原体是卡氏肺孢子虫（在38%的BAL中）和巨细胞病毒（35%）；在17%的BAL中两者同时存在。3组BAL（艾滋病前期、伴有卡波西肉瘤的艾滋病、不伴有卡波西肉瘤的艾滋病）之间的机会性病原体无统计学显著差异。特别是，在这3组中，BAL中巨细胞病毒的检出频率相同。
