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变应性哮喘的内镜检查及支气管肺泡灌洗术(作者译)

[Endoscopy and bronchiolo-alveolar lavage in allergic asthma (author's transl)].

作者信息

Godard P, Aubas P, Calvayrac P, Taib J, Michel F B

出版信息

Nouv Presse Med. 1981 Oct 24;10(38):3141-8.

PMID:7290977
Abstract

The fiberoscope has widened the applications of bronchial endoscopy, facilitated intrabronchial exploration (including bronchiolo-alveolar lavage) and made it feasible to investigate asthmatic patients. In this paper, the authors compare intra-bronchial findings in 34 patients with allergic asthma explored between attacks and in a control group. In all cases, both endoscopy and bronchiolo-alveolar lavage were well tolerated. The bronchi were normal in only 7 patients; the remaining 27 patients had evidence of mucosal changes and hypersecretion. No definite cytological pattern of allergic asthma could be established from cells removed by lavage. The mean total number of cells was the same in patients as in controls. There were individual variations in the number of lymphocytes, but patients with severe asthma had significantly more lymphocytes than those with mild asthma (p less than 0.02). Eosinophilia was common (28/34) but was more pronounced in patients than in controls (p less than 0.01). Patients also had more free mast-cells likely to release histamine in the presence of allergens.

摘要

纤维支气管镜拓宽了支气管内窥镜检查的应用范围,便于进行支气管内探查(包括支气管肺泡灌洗),并使对哮喘患者的检查成为可能。在本文中,作者比较了34例过敏性哮喘患者在发作间期进行探查时的支气管内表现以及与对照组的差异。在所有病例中,内窥镜检查和支气管肺泡灌洗的耐受性均良好。仅7例患者的支气管正常;其余27例患者有黏膜改变和分泌亢进的证据。通过灌洗获取的细胞无法确立过敏性哮喘明确的细胞学模式。患者的细胞总数均值与对照组相同。淋巴细胞数量存在个体差异,但重度哮喘患者的淋巴细胞明显多于轻度哮喘患者(p<0.02)。嗜酸性粒细胞增多常见(28/34),但患者中的嗜酸性粒细胞增多比对照组更明显(p<0.01)。患者中游离肥大细胞也更多,这些肥大细胞在接触过敏原时更易释放组胺。

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