Lawlor Claire M, Choi Sukgi S
Department of Otolaryngology Children's National Health System Washington District of Columbia USA.
Department of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USA.
OTO Open. 2023 Mar 23;7(1):e33. doi: 10.1002/oto2.33. eCollection 2023 Jan-Mar.
Lipid-laden macrophage index (LLMI) has been proposed as a marker for aspiration on bronchoalveolar lavage. It has also been studied as a marker for gastroesophageal reflux and other pulmonary diseases. This review aims to determine the clinical correlation between LLMI and pediatric aspiration.
PubMed (MeSH search), Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) portals through December 17th, 2020.
Preferred Reporting Items for Systematic Review and Meta-Analysis criteria were followed, and a quality assessment of included studies was performed using the Methodological Index for Non-Randomized Studies. Search criteria included all occurrences in the title or abstract of the terms "pulmonary aspiration" and "alveolar macrophages."
Five studies describing 720 patients met inclusion, 3 retrospective case-control studies, and 2 prospective observational studies. Four studies suggested a link between elevated LLMI and aspiration, and 1 found no association. Control groups varied and included healthy nonaspirators to nonaspirators with other pulmonary diseases. Diagnosis of aspiration was not standardized across the studies. Three papers proposed cutoff values for LLMI, all different.
The existing literature indicates that LLMI is not a sensitive or specific marker for aspiration. Further study is needed to define the utility of LLMI in pediatric aspiration.
脂质负荷巨噬细胞指数（LLMI）已被提议作为支气管肺泡灌洗中误吸的标志物。它也被作为胃食管反流和其他肺部疾病的标志物进行研究。本综述旨在确定LLMI与小儿误吸之间的临床相关性。
截至2020年12月17日的PubMed（医学主题词检索）、Scopus和Cochrane对照试验中央注册库（CENTRAL）平台。
遵循系统评价和荟萃分析的首选报告项目标准，并使用非随机研究方法学指数对纳入研究进行质量评估。检索标准包括标题或摘要中出现的所有“肺误吸”和“肺泡巨噬细胞”术语。
五项描述720例患者的研究符合纳入标准，3项回顾性病例对照研究和2项前瞻性观察性研究。四项研究表明LLMI升高与误吸之间存在联系，一项研究未发现关联。对照组各不相同，包括健康的无误吸者和患有其他肺部疾病的无误吸者。各项研究中误吸的诊断并不统一。三篇论文提出了LLMI的临界值，均不相同。
现有文献表明，LLMI不是误吸的敏感或特异性标志物。需要进一步研究来确定LLMI在小儿误吸中的作用。
