Abramson M J, Stone C A, Holmes P W, Tai E H
Faculty of Medicine, University of Newcastle, NSW.
Aust N Z J Med. 1987 Aug;17(4):407-12. doi: 10.1111/j.1445-5994.1987.tb00076.x.
We report 50 immunocompromised patients with pulmonary infiltrates who underwent fibreoptic bronchoscopy, including bronchoalveolar lavage, on 56 occasions. The underlying diseases were mostly lymphoma, leukemia, other malignancies and renal failure. The commonest immunodeficiency factors were chemotherapy, steroids and neutropenia. A positive diagnosis could be made from analysis of the bronchoalveolar lavage on 59% (33/56) occasions. This was a comparable yield to transbronchial lung biopsy 57% (16/27), and superior to proximal airways wash 24% (13/55), or bronchial brushings 29% (10/34). Open lung biopsy added additional diagnostic information in three of the four cases in which it was performed. The most common final diagnoses were bacterial, viral or Pneumocystis carinii pneumonia and recurrent malignancy. We conclude that bronchoalveolar lavage is a safe procedure with a high diagnostic yield in the immunocompromised host with suspected opportunistic pneumonia.
我们报告了50例有肺部浸润的免疫功能低下患者，这些患者接受了56次纤维支气管镜检查，包括支气管肺泡灌洗。基础疾病主要为淋巴瘤、白血病、其他恶性肿瘤和肾衰竭。最常见的免疫缺陷因素是化疗、类固醇和中性粒细胞减少。59%（33/56）的病例通过支气管肺泡灌洗分析可做出阳性诊断。这一诊断率与经支气管肺活检的57%（16/27）相当，优于近端气道冲洗的24%（13/55）或支气管刷检的29%（10/34）。在进行开胸肺活检的4例患者中，有3例获得了额外的诊断信息。最常见的最终诊断为细菌性、病毒性或卡氏肺孢子虫肺炎以及复发性恶性肿瘤。我们得出结论，对于疑似机会性肺炎的免疫功能低下宿主，支气管肺泡灌洗是一种安全且诊断率高的检查方法。
