Labrune S, Chinet T, Collignon M A, Barritault L, Huchon G J
Université de Paris René Descartes, Laboratoire de Biologie et Pharmacologie des Epithelia Respiratoires, France.
Eur Respir J. 1994 Apr;7(4):651-6. doi: 10.1183/09031936.94.07040651.
The aim of this study was to elucidate possible mechanisms of increased epithelial lung clearance in diffuse fibrosing alveolitis (DFA). We investigated the relationships between epithelial lung clearance as assessed by the clearance of aerosolized 99mTc-diethylene-triamine-penta-acetic acid (RC-DTPA), luminal alveolitis as assessed by bronchoalveolar lavage, and pulmonary function, in 30 nonsmokers with DFA. In 14 of these patients, RC-DTPA and lung function were determined before and during therapy with prednisolone (0.5 mg.kg-1 daily). RC-DTPA was higher in patients with DFA (4.45 +/- 2.50%.min-1) than in normal subjects (1.18 +/- 0.31%.min-1). RC-DTPA did not correlate with the number of alveolar neutrophils, but correlated positively with the number of alveolar lymphocytes, and negatively with vital capacity (VC). RC-DTPA decreased from 6.1 +/- 2.8 to 3.8 +/- 1.9%.min-1 with prednisolone. RC-DTPA before prednisolone correlated positively with the prednisolone-associated improvement in VC. We conclude that in patient with DFA, RC-DTPA is increased, and decreases but does not return to normal with corticosteroid therapy. Our data suggest that in DFA the increase in RC-DTPA could be related to the recoil-induced stretch of the respiratory epithelium and to alveolar lymphocytic inflammation.
本研究的目的是阐明弥漫性纤维化肺泡炎（DFA）中肺上皮清除增加的可能机制。我们调查了30名非吸烟DFA患者中雾化99mTc-二乙烯三胺五乙酸清除率（RC-DTPA）评估的肺上皮清除、支气管肺泡灌洗评估的管腔内肺泡炎和肺功能之间的关系。在其中14名患者中，在使用泼尼松龙（每日0.5mg·kg-1）治疗前和治疗期间测定了RC-DTPA和肺功能。DFA患者的RC-DTPA（4.45±2.50%·min-1）高于正常受试者（1.18±0.31%·min-1）。RC-DTPA与肺泡中性粒细胞数量无关，但与肺泡淋巴细胞数量呈正相关，与肺活量（VC）呈负相关。使用泼尼松龙后，RC-DTPA从6.1±2.8降至3.8±1.9%·min-1。泼尼松龙治疗前的RC-DTPA与泼尼松龙治疗后VC的改善呈正相关。我们得出结论，DFA患者中RC-DTPA升高，皮质类固醇治疗后降低但未恢复正常。我们的数据表明，DFA中RC-DTPA的升高可能与呼吸上皮的反冲诱导拉伸和肺泡淋巴细胞炎症有关。
