CAJ | 학술논문

目的了解难治性哮喘气道炎症的粒细胞表型,初步探讨支气管肺泡灌洗术( bronchoavleolar lavage,BAL)在难治性哮喘诊治中的应用价值.方法 31例难治性哮喘患者选择右肺中叶或左肺舌段进行BAL,回收支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)进行细胞分类和细菌培养.结果 31例患者的BALF中中性粒细胞比例均呈不同程度升高,范围分布于8％～97％,其中中性粒细胞比例大于40％者占64.5％,而嗜酸粒细胞比例升高者只有6例,其中3％～6％的5例,54％的1例.BALF培养结果发现,烟曲霉(+)4例,铜绿假单胞菌(+)1例,大肠杆菌(+)1例.结论以中性粒细胞浸润为主的气道炎症表型可能是难治性哮喘的种特征,通过BALF检查有助于难治性哮喘的诊断和制定个体化的治疗.
목적 료해난치성효천기도염증적립세포표형,초보탐토지기관폐포관세술( bronchoavleolar lavage,BAL)재난치성효천진치중적응용개치.방법 31례난치성효천환자선택우폐중협혹좌폐설단진행BAL,회수지기관폐포관세액(bronchoalveolar lavage fluid,BALF)진행세포분류화세균배양.결과 31례환자적BALF중중성립세포비례균정불동정도승고,범위분포우8％～97％,기중중성립세포비례대우40％자점64.5％,이기산립세포비례승고자지유6례,기중3％～6％적5례,54％적1례.BALF배양결과발현,연곡매(+)4례,동록가단포균(+)1례,대장간균(+)1례.결론 이중성립세포침윤위주적기도염증표형가능시난치성효천적 충특정,통과BALF검사유조우난치성효천적진단화제정개체화적치료.
Objective To know about granulocyte phenotype of the refractory asthma airway inflammation,and preliminarily discuss the application value of bronchoalveolar lavage (BAL) in refractory asthma.Methods The 31 cases of patients with refractory asthma undergo the BAL in the middle lobe of right lung or lingual segment of left lobe. And recycle the bronchoalveolar lavage fluid (BALF) to process cell classification and cell culture.Results In the BALF of the 31 patients,the neutrophils ratio rise in varying degrees,the range is distributed in 8％ to 97％,of which the neutrophiis ratio more than 40％ account for 64.5％,and the proportion of eosinophilic granulocyte rise only six cases,3％～6％ in 5 patients,and 54％ in 1 patient.The BALF culture results have found,aspergillus fumigatus ( + ) 4 cases, pseudomonas aeruginosa (+) 1 case,and eseherichia coli(+) 1 case.Conclusions Mainly neutrophils infiltrating in the airway inflammation phenotype may be a way of refractory asthma. It is helpful to the diagnosis of refractory asthma and draw out individuation treatments through the BAL examination.