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支气管肺泡灌洗和经支气管活检在器官移植患者肺炎诊断中的作用

[Role of bronchoalveolar lavage and transbronchial biopsy in the diagnosis of pneumonia in patients with organ transplantation].

作者信息

Arnedillo Muñoz A, Lopez Moya M E, de Lucas Ramos P, Puente Maestu L, Sanchez Juanes M J, Rodriguez Gonzalez-Moro J M, Garcia de Pedro J, Rodriguez de Guzman M C

机构信息

Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid.

出版信息

An Med Interna. 1996 Feb;13(2):59-63.

PMID:8948813
Abstract

Pneumonia in patients with organ transplantation constitutes a very frequent cause of mortality, as a result precocious aetiologic diagnosis is indispensable. The bronchoscopic techniques, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB), constitute fundamental procedures for these diagnoses. We begin this study with the aim of evaluating the profitability obtained with these procedures. 36 bronchoscopies were performed on 29 patients with organ transplantation, in all of them we realized BAL and in 20 TBB. We confirm the presence of pneumonia in 30 (in 15 of them we had performed TBB), the BAL was diagnostic in 20 cases (66.6%) and the TBB in 7 (46.6%). With both, BAL and TBB, we obtained a sensitivity of 80% and a specificity of 75%. We isolated 10 bacteria, 8 Citomegalovirus (CMV), 6 Pneumocystis carinii and 2 Aspergillus fumigatus. The BAL and the TBB contributed significantly in the aetiologic diagnosis of pneumonia in patients with organ transplantation, consequently we consider them basic tools in the management of these infections.

摘要

器官移植患者的肺炎是导致死亡的常见原因,因此早期病因诊断必不可少。支气管镜检查技术,即支气管肺泡灌洗(BAL)和经支气管活检(TBB),是这些诊断的基本方法。我们开展本研究旨在评估这些检查方法的有效性。对29例器官移植患者进行了36次支气管镜检查,所有患者均接受了BAL,20例接受了TBB。我们确诊了30例肺炎(其中15例进行了TBB),BAL诊断出20例(66.6%),TBB诊断出7例(46.6%)。联合使用BAL和TBB,敏感性为80%,特异性为75%。我们分离出10种细菌、8株巨细胞病毒(CMV)、6株卡氏肺孢子虫和2株烟曲霉。BAL和TBB对器官移植患者肺炎的病因诊断有显著贡献,因此我们认为它们是管理这些感染的基本工具。

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