Ratjen F, Bredendiek M, Brendel M, Meltzer J, Costabel U
Dept of Paediatrics, University of Essen, Germany.
Eur Respir J. 1994 Oct;7(10):1865-70. doi: 10.1183/09031936.94.07101865.
Bronchoalveolar lavage (BAL) is increasingly used in the assessment of pulmonary diseases in children. However, reference values for cellular and non-cellular constituents of BAL fluid in children are lacking. We have studied the differential cytology of BAL fluid in 48 children aged 3-16 years (mean age +/- SD 7.9 +/- 3.5 yrs) undergoing elective surgery for nonpulmonary illnesses. A flexible bronchoscope (Pentax 3.5 or 4.9 mm) was wedged in the middle lobe or one of its segments. BAL was performed with 3x1 ml-kg-1 body weight of normal saline warmed to body temperature. The first sample was studied separately; subsequent samples were pooled for analysis. The mean recovery was 58 +/- 15%. Significantly more granulocytes and less lymphocytes were found in the first, as compared to the pooled, sample. Total cell counts were highly variable and ranged from 0.5-57.1 x 10(4) ml-1. Macrophages were the predominant cell type, with a mean percentage of 81.2 +/- 12.7%. The relative proportion of lymphocytes was higher than that reported in most studies of adult volunteers (16.1 +/- 2.4%). No age dependency was observed for either cell type. The mean percentage of granulocytes was 2.5 +/- 3.3%. Absolute granulocyte counts were significantly higher in children under 8 yrs of age. This study provides the first reference data on BAL differential cytology in children without pulmonary disease and will be the basis for future investigations of BAL in paediatric lung diseases.
支气管肺泡灌洗（BAL）在儿童肺部疾病评估中的应用越来越广泛。然而，目前缺乏儿童BAL液细胞成分和非细胞成分的参考值。我们对48例3至16岁（平均年龄±标准差7.9±3.5岁）因非肺部疾病接受择期手术的儿童的BAL液进行了细胞分类学研究。使用一根可弯曲支气管镜（宾得3.5或4.9毫米）楔入中叶或其某一段。用3×1毫升/千克体重、预热至体温的生理盐水进行BAL。第一个样本单独研究；后续样本合并进行分析。平均回收率为58±15%。与合并样本相比，第一个样本中发现的粒细胞明显更多，淋巴细胞更少。总细胞计数变化很大，范围为0.5 - 57.1×10⁴/毫升。巨噬细胞是主要细胞类型，平均百分比为81.2±12.7%。淋巴细胞的相对比例高于大多数成年志愿者研究报告的比例（16.1±2.4%）。未观察到任何一种细胞类型与年龄有关。粒细胞的平均百分比为2.5±3.3%。8岁以下儿童的绝对粒细胞计数明显更高。本研究提供了无肺部疾病儿童BAL细胞分类学的首批参考数据，将作为未来儿科肺部疾病BAL研究的基础。
