Smith S F, Guz A, Winning A J, Cooke N T, Burton G H, Tetley T D
Dept of Medicine, Charing Cross and Westminster Medical School, London, UK.
Eur Respir J. 1988 Oct;1(9):792-800.
This study describes two new techniques of lung lavage which selectively remove material from the central airways, or from the lung below the seventh generation. Bronchograms confirmed that discrete regions of the lung were washed by central lavage (CL; maximum airway diameter approximately 6.5 mm) and peripheral lavage (PL; maximum airway diameter approximately 1.3 mm), and that both could be clearly distinguished from conventional bronchoalveolar lavage (BAL). These techniques were used to establish whether or not large-airway proteins made a major contribution to the protein profile of BAL. Twenty consecutive patients undergoing routine fibreoptic bronchoscopy were investigated. More bronchial mucus proteinase inhibitor per unit albumin and per unit total measured antiproteinase was present in CL than PL or BAL. In contrast alpha 1-proteinase inhibitor per unit albumin and as a percentage of total measured antiproteinase was lower in CL than in other lavage types. There were no differences in elastase activity, irrespective of the way in which the data were expressed. As no differences were found between BAL and PL for any of the variables measured, it was concluded that in the subjects studied the contribution of CL proteins to BAL was minimal.
本研究描述了两种新的肺灌洗技术，可选择性地从中央气道或从第七代以下的肺组织中清除物质。支气管造影证实，中央灌洗（CL；最大气道直径约6.5毫米）和外周灌洗（PL；最大气道直径约1.3毫米）可冲洗肺的离散区域，且两者均可与传统的支气管肺泡灌洗（BAL）明显区分。这些技术用于确定大气道蛋白质是否对BAL的蛋白质谱有主要贡献。对20例接受常规纤维支气管镜检查的连续患者进行了研究。每单位白蛋白和每单位总测量抗蛋白酶中的支气管黏液蛋白酶抑制剂在CL中比在PL或BAL中更多。相比之下，每单位白蛋白的α1-蛋白酶抑制剂以及作为总测量抗蛋白酶的百分比在CL中比在其他灌洗类型中更低。无论数据如何表达，弹性蛋白酶活性均无差异。由于在测量的任何变量中BAL和PL之间均未发现差异，因此得出结论，在所研究的受试者中，CL蛋白质对BAL的贡献最小。
