支气管肺泡灌洗术液细胞学检查在儿童肺部浸润诊断中的意义

The Significance of Bronchoalveolar Lavage Fluid Cytology in Diagnosing Lung Infiltrates in Children.

作者信息

Selimovic Amina, Mujicic Ermina, Milisic Selma, Pejicic Tanja, Rancic Milan, Mesihovic-Dinarevic Senka, Lukic-Bilela Lada, Moro Mahir

机构信息

Pediatric Clinic of the University Clinical Center of Sarajevo, Sarajevo, Bosnia and Herzegovina.

Department for Cardioanesthesiology, Clinic for anesthesiology, reanimatology and intensive care of the University Clinical Center of Sarajevo, Sarajevo, Bosnia and Herzegovina.

出版信息

Med Arch. 2016 Feb;70(1):27-30. doi: 10.5455/medarh.2016.70.27-30. Epub 2016 Jan 31.

DOI:10.5455/medarh.2016.70.27-30

PMID:26980927

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4779357/

Abstract

AIM

The aim of this research is to show why is it important in diagnosing children with lung infiltrates.

METHODS

Our study included 50 children with lung infiltrates during period 2005-2012, and was conducted on Pediatric Clinic of the University Clinical Center Sarajevo. We sent all cytological BAL analyses to the University Clinical Center Sarajevo. Cytology was performed by direct microscopy. BAL cytology was performed by the principle of sending samples for centrifuging, 12000 revolutions during a 10 min Shandon-cyto spin. Then the centrifuged sample is dried in the air during 1-2 hours, and is then dyed under the May-Grünwald-Giemsa staining, and analyzed under the Olympus BX41 microscope.

RESULTS

Nosocomial pneumonia has occurred in 32% children, acquired pneumonia in 38%, and 30% children had a lung infiltrates. 6 (12%) of children were younger then 1 year old, 23 (46%) children were between 1 to 5 years, 14 (28%) of children were between 5 to 10 ages, and 7 (14%) of children were between 10-15 ages. The most of the changes in observed children took place on the right lung, 34%, while 26% occurred on the left side, 22% were normal and 18% changes have affected both lungs, right and left. Percentage of cells in cytological smear in children with BAL were: cylindrical cells 28%, lung macrophage 26%, lymphocytes 17%, detritus 17% and phlegm 12%. Erythrocyte sedimentation rate (ESR) in children with BAL was up to 10-52%, to 50-30%, while ESR after first hour was above 50-18 %.

CONCLUSION

Clinical parameters and local inflammation of the affected lobe are associated with positive bronchoalveolar cytology lavage findings.

摘要

目的

本研究的目的是表明其在诊断儿童肺部浸润方面为何重要。

方法

我们的研究纳入了2005年至2012年期间50例患有肺部浸润的儿童，研究在萨拉热窝大学临床中心儿科诊所进行。我们将所有细胞学支气管肺泡灌洗分析送至萨拉热窝大学临床中心。细胞学检查通过直接显微镜检查进行。支气管肺泡灌洗细胞学检查按照将样本送去离心的原则进行，在Shandon细胞离心机中以12000转/分钟离心10分钟。然后将离心后的样本在空气中干燥1至2小时，接着在美蓝-吉姆萨染色下染色，并在奥林巴斯BX41显微镜下进行分析。

结果

32%的儿童发生了医院获得性肺炎，38%为社区获得性肺炎，30%的儿童有肺部浸润。6名（12%）儿童年龄小于1岁，23名（46%）儿童年龄在1至5岁之间，14名（28%）儿童年龄在5至10岁之间，7名（14%）儿童年龄在10至15岁之间。观察到的儿童中，大部分病变发生在右肺，占34%，而26%发生在左肺，22%正常，18%的病变累及双侧肺。支气管肺泡灌洗儿童的细胞学涂片中细胞百分比为：柱状细胞28%，肺巨噬细胞26%，淋巴细胞17%，碎屑17%，痰液12%。支气管肺泡灌洗儿童的红细胞沉降率（ESR）在1小时内高达10 - 52%，在1小时后为50 - 30%，而1小时后ESR高于50 - 18%。