Gellert A R, Langford J A, Winter R J, Uthayakumar S, Sinha G, Rudd R M
Thorax. 1985 Jul;40(7):508-14. doi: 10.1136/thx.40.7.508.
Thirty two patients with asbestosis were assessed by means of bronchoalveolar lavage (27 patients) and the half time clearance from lungs to blood (T1/2LB) of an inhaled aerosol of diethylenetriamine pentacetate (DTPA) labelled with technetium 99m (32 patients). T1/2LB was also measured in 20 non-smoking normal individuals and 17 smokers without a history of exposure to asbestos. Thirteen patients (46%) showed an increase in the percentage of neutrophils with or without an increase in the percentage of eosinophils and eight (29%) showed an increased percentage of lymphocytes. The number of neutrophils plus eosinophils expressed as a percentage of the total count was positively correlated with the length of the history of disease (r = 0.53, p less than 0.025) and greater percentages were associated with more severe impairment of lung function. Smokers had lower percentages of lymphocytes than non-smokers (p less than 0.002) and showed increased proportions of neutrophils and eosinophils more often than non-smokers (p less than 0.05). In 18 non-smokers with asbestosis the mean T1/2LB was 33.8 (range 10.0-62.0) minutes, significantly less than 57.2 (30.5-109) minutes in 20 non-smoking normal subjects (p less than 0.002). In non-smokers shorter T1/2LB correlated with a longer time since first exposure to asbestos (r = -0.65, p less than 0.005), longer duration of exposure (r = -0.70, p less than 0.001), and a shorter time since last exposure (r = 0.59, p less than 0.01). Shorter T1/2LB was also associated with increased inflammatory activity as shown by higher bronchoalveolar lavage cell counts (r = -0.53, p less than 0.025) and higher combined percentages of neutrophils, eosinophils, and lymphocytes (r = -0.47, p less than 0.05). The techniques of bronchoalveolar lavage and measurement of inhaled solute clearance may be useful in assessing inflammatory activity in asbestosis.
对32例石棉肺患者进行了评估，其中27例采用支气管肺泡灌洗，32例测量了吸入的99m锝标记的二乙三胺五乙酸（DTPA）气雾剂从肺到血液的半衰期清除率（T1/2LB）。还对20名不吸烟的正常人和17名无石棉接触史的吸烟者测量了T1/2LB。13例患者（46%）中性粒细胞百分比增加，伴或不伴嗜酸性粒细胞百分比增加，8例（29%）淋巴细胞百分比增加。中性粒细胞加嗜酸性粒细胞数量占总数的百分比与疾病史长度呈正相关（r = 0.53，p < 0.025），百分比越高，肺功能损害越严重。吸烟者的淋巴细胞百分比低于不吸烟者（p < 0.002），中性粒细胞和嗜酸性粒细胞比例增加的情况比不吸烟者更常见（p < 0.05）。18例不吸烟的石棉肺患者的平均T1/2LB为33.8（10.0 - 62.0）分钟，显著低于20名不吸烟正常受试者的57.2（30.5 - 109）分钟（p < 0.002）。在不吸烟者中，较短的T1/2LB与首次接触石棉后的时间较长（r = -0.65，p < 0.005）、接触持续时间较长（r = -0.70，p < 0.001）以及上次接触后的时间较短（r = 0.59，p < 0.01）相关。较短的T1/2LB还与炎症活动增加相关，如支气管肺泡灌洗细胞计数较高（r = -0.53，p < 0.025）以及中性粒细胞、嗜酸性粒细胞和淋巴细胞的联合百分比较高（r = -0.47，p < 0.05）。支气管肺泡灌洗技术和吸入溶质清除率测量可能有助于评估石棉肺的炎症活动。
