Kelly C, Ward C, Bird G, Hendrick D, Walters H
Department of Medicine, Newcastle General Hospital, U.K.
Respir Med. 1989 Mar;83(2):107-10. doi: 10.1016/s0954-6111(89)80223-9.
We have studied the effects of filtering mucus from bronchoalveolar lavage (BAL) fluid on its cellular contents. We examined BAL fluid from 18 patients without excessive endobronchial mucus, and from three patients with bronchiectasis. In the non-bronchiectatic subjects there was a fall of 18% in mean absolute cell count from 2.66 +/- SD 1.9 x 10(9) l-1 to 2.18 +/- 1.4 x 10(9) l-1 (P less than 0.05) as a result of filtration. This was due to a selective loss of macrophages and there were no significant changes in the absolute numbers of either lymphocytes or neutrophils. The differential macrophage count fell from a mean of 82 +/- 14% to 76 +/- 16%, while the mean differential lymphocyte count rose from 14 +/- 7% to 19 +/- 9% and the mean differential neutrophil count increased slightly from 4 +/- 4% to 5 +/- 4%. In the three patients with bronchiectasis the absolute cell counts were grossly raised, due almost entirely to an excess of neutrophils. In these patients, filtration reduced the absolute macrophage count by 61% and the absolute neutrophil count by 27%. Overall, change in absolute cell count correlated significantly with mucus volume (r = 0.76, P less than 0.05). Removal of mucus by filtration affects absolute cell count and may have a selective effect on cell numbers. If filtration of BAL fluid is unavoidable, its effect on cell counts should be clearly established if data from different centres are to be meaningfully compared.
我们研究了对支气管肺泡灌洗（BAL）液中的黏液进行过滤对其细胞成分的影响。我们检测了18例无过多支气管内黏液患者以及3例支气管扩张患者的BAL液。在非支气管扩张受试者中，过滤导致平均绝对细胞计数下降了18%，从2.66±标准差1.9×10⁹/L降至2.18±1.4×10⁹/L（P<0.05）。这是由于巨噬细胞的选择性丢失，淋巴细胞和中性粒细胞的绝对数量没有显著变化。巨噬细胞分类计数从平均82±14%降至76±16%，而淋巴细胞分类平均计数从14±7%升至19±9%，中性粒细胞分类平均计数从4±4%略有增加至5±4%。在3例支气管扩张患者中，绝对细胞计数大幅升高，几乎完全是由于中性粒细胞过多。在这些患者中，过滤使巨噬细胞绝对计数减少了61%，中性粒细胞绝对计数减少了27%。总体而言，绝对细胞计数的变化与黏液量显著相关（r = 0.76，P<0.05）。通过过滤去除黏液会影响绝对细胞计数，并且可能对细胞数量产生选择性影响。如果不可避免要对BAL液进行过滤，那么在对不同中心的数据进行有意义的比较时，应明确其对细胞计数的影响。
