Baughman R P, Sternberg R I, Hull W, Buchsbaum J A, Whitsett J
Department of Internal Medicine, University of Cincinnati Medical Center, Ohio.
Am Rev Respir Dis. 1993 Mar;147(3):653-7. doi: 10.1164/ajrccm/147.3.653.
Abnormalities have been previously noted in the lipid content of the lavage fluid of patients with bacterial pneumonia. In order to determine if these changes were also seen in surfactant apoproteins, we studied levels of surfactant protein A (SP-A) in patients with bacterial pneumonia. Patients without human immunodeficiency virus who were being evaluated for pulmonary infiltrates underwent bronchoscopy with bronchoalveolar lavage (BAL). Twenty-two patients with pneumonia, 12 caused by gram-positive organisms (Gm+ PNEU) and 10 caused by gram-negative organisms (Gm- PNEU), were compared with 10 patients with idiopathic pulmonary fibrosis (IPF) and 11 control subjects (CON). The percentage of neutrophils in the BAL was significantly higher in the patients with IPF and the pneumonia groups than in the control group (CON: mean, 1; range, 0 to 3. IPF: mean, 26; range, 13 to 42). Gm+ PNEU: mean, 33; range, 8 to 99. Gm- PNEU: mean, 64; range, 10 to 92; p < 0.0001). The amount of SP-A in the BAL fluid was similar for the CON and the IPF groups (CON: mean, 15; range, 5.75 to 26.5 micrograms/ml BAL. IPF: mean, 18.4; range, 6.49 to 45.64 micrograms/ml), whereas both pneumonia groups had significantly less SP-A (Gm- PNEU: mean, 5.54; range, 0.58 to 12.7. G+ PNEU: mean, 1.93; range, 0.47 to 6.74; p < 0.001). There was significantly less SP-A in the Gm+ PNEU group than in the Gm- PNEU group (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
此前已注意到细菌性肺炎患者灌洗液中的脂质含量存在异常。为了确定这些变化在表面活性物质载脂蛋白中是否也存在，我们研究了细菌性肺炎患者的表面活性物质蛋白A（SP-A）水平。对正在接受肺部浸润评估且无人类免疫缺陷病毒的患者进行支气管镜检查及支气管肺泡灌洗（BAL）。将22例肺炎患者（12例由革兰氏阳性菌引起，即Gm + PNEU；10例由革兰氏阴性菌引起，即Gm - PNEU）与10例特发性肺纤维化（IPF）患者及11例对照者（CON）进行比较。IPF患者和肺炎组BAL中的中性粒细胞百分比显著高于对照组（CON：平均值为1；范围为0至3。IPF：平均值为26；范围为13至42。Gm + PNEU：平均值为33；范围为8至99。Gm - PNEU：平均值为64；范围为10至92；p < 0.0001）。CON组和IPF组BAL液中SP-A的量相似（CON：平均值为15；范围为5.75至26.5微克/毫升BAL。IPF：平均值为18.4；范围为6.49至45.64微克/毫升），而两个肺炎组的SP-A均显著减少（Gm - PNEU：平均值为5.54；范围为0.58至12.7。G + PNEU：平均值为1.93；范围为0.47至6.74；p < 0.001）。Gm + PNEU组的SP-A明显少于Gm - PNEU组（p < 0.02）。（摘要截取自250字）
