Tomoda T, Takai A
Department of Clinical Pathology, Osaka Medical College, Takatsuki, Japan.
Kekkaku. 1994 Dec;69(12):743-9.
The defence factors against infection in sputum and bronchoalveolar lavage fluid (BALF) of patients with pulmonary tuberculosis were measured. As the defence factors, lactoferrin, lysozyme and secretory IgA (sIgA) in sputum or BALF of patients with bacilli (+) or (-) tuberculosis were measured and compared. Lactoferrin in sputum was significantly higher in patients with sputum smear positive tuberculosis compared with patients with smear and culture negative tuberculosis. SIgA in sputum was significantly higher in smear negative and culture positive cases compared with culture negative cases. As to the lysozyme in sputum, significant difference was not proved between each group. The level of these factors in BALF did not show significant difference between bacilli (+) and (-) cases. Neither significant correlation was observed among the level of three defence factors in sputum or BALF, nor between the number of leucocyte and tubercle bacilli in sputum. In tubercle bacilli positive group, however, significant positive correlation between the number of leucocyte and lactoferrin in sputum was found. In vitro experiments, high concentration of lactoferrin or lysozyme inhibited the growth of standard strain of tubercle bacilli (H37Rv) and BCG. The results suggest that the measurement of lactoferrin, lysozyme and sIgA in sputum or BALF is useful to determine the clinical activity of tuberculosis.
对肺结核患者痰液和支气管肺泡灌洗液（BALF）中的抗感染防御因子进行了测定。作为防御因子，对痰菌阳性或阴性肺结核患者痰液或BALF中的乳铁蛋白、溶菌酶和分泌型IgA（sIgA）进行了测定和比较。痰涂片阳性肺结核患者痰液中的乳铁蛋白显著高于痰涂片和培养均阴性的患者。涂片阴性且培养阳性病例痰液中的sIgA显著高于培养阴性病例。关于痰液中的溶菌酶，各组之间未证实有显著差异。BALF中这些因子的水平在菌阳和菌阴病例之间未显示出显著差异。痰液或BALF中三种防御因子的水平之间，以及痰液中白细胞数量与结核杆菌数量之间均未观察到显著相关性。然而，在结核杆菌阳性组中，发现痰液中白细胞数量与乳铁蛋白之间存在显著正相关。体外实验中，高浓度的乳铁蛋白或溶菌酶可抑制结核杆菌标准菌株（H37Rv）和卡介苗的生长。结果表明，测定痰液或BALF中的乳铁蛋白、溶菌酶和sIgA有助于确定结核病的临床活动性。
