Edelson J D, Hyland R H, Ramsden M, Chamberlain D W, Kortan P, Meindok H O, Klein M H, Braude A C, Lee P, Rebuck A S
J Rheumatol. 1985 Oct;12(5):957-63.
Twenty-five patients with systemic sclerosis were studied by chest radiography, lung function, esophageal motility, gallium-67 (67Ga) lung scanning and bronchoalveolar lavage (BAL). Alveolar inflammation, as defined by an elevation of proportional BAL lymphocyte or neutrophil counts, or increased thoracic uptake of 67Ga was found in 16 patients. An NIH gallium index greater than 65 index units identified a subgroup of patients with a significantly higher proportional BAL lymphocyte count (13.7 +/- 8.5 vs 5.6 +/- 3.1, p less than 0.0005). The presence of an abnormal chest radiograph correlated with physiologic evidence of lung restriction (p less than 0.01), and an elevation of proportional BAL lymphocyte count (15.5 +/- 8.2 vs 6.6 +/- 5.1, p less than 0.01). Eight patients receiving oral penicillamine therapy had significantly lower BAL lymphocyte counts compared to untreated patients (4.7 +/- 3.6 vs 11.3 +/- 7.7, p less than 0.05). We suggest that alveolar inflammation in scleroderma is characterized by lymphocyte accumulation and increased thoracic uptake of gallium.
对25例系统性硬化症患者进行了胸部X线摄影、肺功能、食管动力、镓-67（67Ga）肺扫描和支气管肺泡灌洗（BAL）检查。16例患者发现有肺泡炎症，表现为BAL淋巴细胞或中性粒细胞比例升高，或67Ga胸部摄取增加。NIH镓指数大于65指数单位可识别出一组BAL淋巴细胞比例显著更高的患者亚组（13.7±8.5对5.6±3.1，p<0.0005）。胸部X线片异常与肺限制性生理证据相关（p<0.01），且与BAL淋巴细胞比例升高相关（15.5±8.2对6.6±5.1，p<0.01）。与未治疗患者相比，8例接受口服青霉胺治疗的患者BAL淋巴细胞计数显著更低（4.7±3.6对11.3±7.7，p<0.05）。我们认为，硬皮病中的肺泡炎症以淋巴细胞积聚和镓胸部摄取增加为特征。
