Daniele R P, Elias J A, Epstein P E, Rossman M D
Ann Intern Med. 1985 Jan;102(1):93-108. doi: 10.7326/0003-4819-102-1-93.
Bronchoalveolar lavage has emerged as a useful technique for the study of pulmonary interstitial disorders. Several types of information are provided by the evaluation of lavage fluid. First, the identification of cellular constituents helps to separate inflammatory processes in which lymphocytes predominate (for example, sarcoidosis, hypersensitivity pneumonitis, and berylliosis) from those in which neutrophils or macrophages predominate (for example, idiopathic pulmonary fibrosis and histiocytosis X). Second, the cells removed during lavage can be studied for their immune properties and function; tested with specific antigens, in diseases such as berylliosis and hypersensitivity pneumonitis; and examined for the presence of unique surface antigens with monoclonal antibodies (for example, histiocytosis X). Third, in conjunction with scanning electron microscopy and electron probe analysis, lavage makes possible the identification of inorganic particles in alveolar macrophages of patients with pneumoconiotic lung disease. Finally, although lavage is still an investigative procedure for most pulmonary disorders, it has an established role in the diagnosis of opportunistic infections in the immunocompromised patient.
支气管肺泡灌洗已成为研究肺间质疾病的一项有用技术。对灌洗液体的评估可提供几种类型的信息。首先，细胞成分的鉴定有助于将以淋巴细胞为主的炎症过程（例如结节病、过敏性肺炎和铍中毒）与以中性粒细胞或巨噬细胞为主的炎症过程（例如特发性肺纤维化和组织细胞增多症X）区分开来。其次，灌洗过程中清除的细胞可研究其免疫特性和功能；在铍中毒和过敏性肺炎等疾病中用特定抗原进行检测；并用单克隆抗体检查是否存在独特的表面抗原（例如组织细胞增多症X）。第三，结合扫描电子显微镜和电子探针分析，灌洗能够识别尘肺患者肺泡巨噬细胞中的无机颗粒。最后，尽管对于大多数肺部疾病来说，灌洗仍然是一种研究方法，但它在免疫功能低下患者机会性感染的诊断中具有既定作用。
