Vestbo J, Nielsen T L, Junge J, Lundgren J D
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark.
Chest. 1993 Jul;104(1):109-13. doi: 10.1378/chest.104.1.109.
Correlations between semiquantitative amounts of Pneumocystis carinii (PC), the degree of inflammation, and the severity of pneumonia were analyzed in 58 patients with PC pneumonia (PCP). Material from both transbronchial biopsies (TBBs; n = 39) and bronchoalveolar lavage fluid (BALF; n = 57) was examined. In the TBB the amount of PC correlated strongly with overall inflammation in the interstitium (Kendall correlation coefficient [Kcc] = 0.59; p < 0.0001), type 2 pneumocyte proliferation, and edema formation. The amount of PC in the TBB also correlated with interstitial accumulation of neutrophils (Kcc = 0.54; p = 0.0001), lymphocytes, and macrophages. In BALF the amount of PC correlated with edema formation and type 2 pneumocyte proliferation in the TBB but not with the percentage of neutrophils, lymphocytes, or macrophages in BALF. The amount of PC in the BALF and the percentage of neutrophils in the BALF correlated significantly with Po2 and the serum lactate dehydrogenase (LDH) level. Neither short-term nor long-term survival was affected by the amount of PC, inflammatory markers in the TBB, inflammatory cells in BALF, Po2, or the serum LDH levels. In conclusion, the amount of PC is associated with the extent of the acute inflammatory reaction in the lung in PCP associated with human immunodeficiency virus (HIV).
对58例卡氏肺孢子虫肺炎（PCP）患者的卡氏肺孢子虫（PC）半定量含量、炎症程度和肺炎严重程度之间的相关性进行了分析。对经支气管活检（TBB；n = 39）和支气管肺泡灌洗液（BALF；n = 57）的材料均进行了检查。在TBB中，PC的含量与间质中的总体炎症（肯德尔相关系数[Kcc]=0.59；p<0.0001）、Ⅱ型肺泡上皮细胞增殖和水肿形成密切相关。TBB中PC的含量也与中性粒细胞（Kcc = 0.54；p = 0.0001）、淋巴细胞和巨噬细胞的间质积聚相关。在BALF中，PC的含量与TBB中的水肿形成和Ⅱ型肺泡上皮细胞增殖相关，但与BALF中中性粒细胞、淋巴细胞或巨噬细胞的百分比无关。BALF中PC的含量和BALF中中性粒细胞的百分比与动脉血氧分压（Po2）和血清乳酸脱氢酶（LDH）水平显著相关。PC的含量、TBB中的炎症标志物、BALF中的炎症细胞、Po2或血清LDH水平均不影响短期或长期生存率。总之，在与人类免疫缺陷病毒（HIV）相关的PCP中，PC的含量与肺部急性炎症反应的程度相关。
