支气管肺泡灌洗液中分支杆菌检查方法的研究

目的 :研究痰涂片阴性的肺结核病人支气管肺泡灌洗液 (BAL F)标本的最佳检查方法。方法 :采用直接涂片法、沉淀集菌法、改良罗氏培养法和 BACTEC快速培养法进行分支杆菌检测。结果 :直接涂片法检出 4例 ,阳性率 2 .6 % ;沉淀集菌法检出 18例 ,阳性率 11.6 % ;改良罗氏培养法检出 2 8例 ,阳性率 18.1% ;BACTEC快速培养法检出 46例 ,阳性率 2 9.7%。结论 :支气管肺泡灌洗液检查分支杆菌 ,最好是沉淀集菌法和改良罗氏培养法同时进行 ,才能达到高的检出率。     

支气管肺泡灌洗液中分支枝杆菌检查方法的研究

目的：研究谈涂片阴性的肺结核病人支气管肺泡灌洗液（ＢＡＬＦ）标本的最佳检查方法。方法：采用直接涂片法、沉淀集菌法、改良罗氏培养法和ＢＡＣＴＥＣ快速地进行分支杆菌检测。结果：直接涂片法检出４例,阳性率２．６％,沉淀集菌法检出１８例,阳性率１１．６％,改良罗氏培养法检测出２８例,阳性率１８．１％;ＢＡＣＴＥＣ快速培养法检出４６例,阳性率２９．７％。结论：支气和肺泡灌洗液检查分支杆菌,最好是沉淀集菌法和发言发罗氏培养法同时进行,才能达到高的检出率。     

支气管肺泡灌洗液的细胞形态学检查

我院2年前开展了支气管肺泡灌洗液的细胞形态学检查,为间质性肺病及肺部创伤、感染的诊断提供了有效依据,现报道如下。     

支气管肺泡灌洗液抗酸菌涂片诊断可疑肺结核52例分析

目的 :探讨支气管肺泡灌洗液涂片查抗酸菌对可疑肺结核的诊断价值。方法 :采用OLYMPUSB30型纤维支气管镜在相应病变肺段所属支气管分二次注入无菌生理盐水 5 0ml,负压吸引回收液 ,经过滤离心 ,取沉淀物涂片行抗酸染色。结果 :支气管肺泡灌洗液涂片抗酸染色阳性率 36 .5 % ,加术     

液基夹层杯技术检测支气管肺泡灌洗液中抗酸杆菌对菌阴肺结核的诊断价值

目的评估利用液基夹层杯离心涂片集菌技术检测支气管肺泡灌洗液中抗酸杆菌对菌阴肺结核的临床诊断价值。方法选取我院收治的106例菌阴肺结核患者,所有患者均进行支气管肺泡灌洗液液基夹层杯离心涂片集菌法,荧光定量PCR(FQ-PCR)法,罗氏培养进行抗酸杆菌检测。并通过与罗氏培养法的比较分析液基夹层杯离心涂片集菌法的灵敏度、特异度及临床应用价值。结果罗氏培养法和液基夹层杯离心涂片集菌法对临床确诊的菌阴肺结核患者支气管肺泡灌洗液抗酸杆菌检出率分别为66.0%,70.7%,两者的阳性率比较,差异无统计学意义(χ~2=1.231,P=0.267,P0.05)。结论液基夹层杯离心涂片集菌法检测支气管肺泡灌洗液抗酸杆菌,具有快速、敏感度和特异度较高的优点,对肺结核具有较高的诊断价值,为痰涂片阴性及无痰患者提供良好的诊断依据。     

支气管肺泡灌洗

<正> 支气管肺泡灌洗(Bronchoalveolar Lavage,BAL)这一非创伤性的检查方法,为我们了解肺的炎症和免疫效应细胞的功能提供了很大的帮助,因而有肺的“液态”活检之称,现已被临床广泛采用。BAL对了解不同肺泡炎的符点,确定肺间质性疾病的活     

检测支气管灌洗液中抗酸杆菌的方法学研究

目的探讨捡测支气管灌洗液中抗酸杆菌的最佳方法。方法对155例痰涂片阴性疑似肺结核患者的支气管灌洗液采用涂片、集菌、改良罗氏培养法及Bactec培养法4种不同的检测方法检测抗酸杆菌。结果阳性检出率直接涂片法为2．6%,集菌法为11．6％,改良罗氏培养法为18．1％,Bactec培养法为31．6％;集菌、培养法与直接涂片法抗酸杆菌的阳性检出率比较均有显著性差异（P〈0．05）。结论对疑似肺结核患者支气管灌洗液进行抗酸杆菌检测时,最好采用集菌和培养法同时进行,才能为临床诊治提供最有价值的资料。     

Surfactant protein A in bronchoalveolar lavage fluid.

We measured surfactant protein A and phosphatidylcholine in the bronchoalveolar lavage fluid from healthy volunteers and several groups of patients with lung diseases to obtain information on surfactant in the lung. We developed three types of enzyme-linked immunosorbent assays that used combinations of polyclonal antiserum and monoclonal antibodies. Phosphatidylcholine was assessed by enzymatic measurement. The median amounts of surfactant protein A in bronchoalveolar lavage fluid determined by the enzyme-linked immunosorbent assay with monoclonal antibodies were as follows: control subjects (n = 10), 2.82 mg/L (range, 0.92 to 5.17 mg/L); patients with asthma (n = 13), 1.89 mg/L (range, 0.45 to 2.95 mg/L); and patients with pulmonary sarcoidosis (n = 20), 2.98 mg/L (range, 0.68 to 7.02 mg/L). The median phosphatidylcholine concentrations in the bronchoalveolar lavage fluid were as follows: control subjects (n = 10), 20 mumol/L (range, 3 to 37 mumol/L); patients with asthma (n = 12), 24 mumol/L (range, 3 to 55 mumol/L); and patients with pulmonary sarcoidosis (n = 20), 26 mumol/L (range, 4 to 76 mumol/L). As a group, the patients with asthma had less surfactant protein A in bronchoalveolar lavage fluid than did the control subjects (Mann-Whitney U test, p less than 0.05). The surfactant protein A levels measured by the enzyme-linked immunosorbent assay with polyclonal antiserum and by a competitive enzyme-linked immunosorbent assay were also lower in bronchoalveolar lavage fluid from patients with asthma than in that from control subjects. The phosphatidylcholine concentrations in all groups were similar.(ABSTRACT TRUNCATED AT 250 WORDS)     

流式细胞仪检测肺泡灌洗液T淋巴细胞亚群对肺部疾患的诊断价值

目的用流式细胞术免疫荧光三色分析法检测肺泡灌洗液中T淋巴细胞亚群,探讨其对肺部恶性肿瘤的意义。方法采用流式细胞术与CD4-FITC/CD8-PE/CD3-PerCP三色荧光抗体检测肺泡灌洗液T淋巴细胞亚群,以SSC/CD3-PerCP圈出T淋巴细胞群,分析肺良性与恶性疾病患者肺泡灌洗液中TH(CD3 CD4 )及Ts(CD3 CD8 )细胞占T淋巴细胞的百分比。结果肺良性疾病组Ts细胞占T淋巴细胞的(44.54±9.56)%,TH细胞占(49.28±12.88)%,TH/Ts比值为1.13±0.29;肺恶性肿瘤组Ts细胞占T淋巴细胞的(65.11±7.77)%,TH细胞占(34.57±6.65)%,TH/Ts比值为0.54±0.19。与良性病变组比较,恶性组TH下降(P<0.05),TH/Ts比值显著下降(P<0.01),而Ts显著升高(P<0.01)。结论流式细胞术可用于检测肺泡灌洗液中T淋巴细胞亚群,有助于分析患者肺泡局部细胞免疫功能。     

Leukotriene A4 hydrolase in human bronchoalveolar lavage fluid.

We examined cell-free human bronchoalveolar lavage fluid (BALF) for enzymes of the 5-lipoxygenase pathway. BALF was obtained from six patients who were active smokers and six nonsmokers. Enzymatic activity in cell-free BALF was assessed by specific assays for leukotriene (LT) A4 hydrolase, 5-lipoxygenase, and LTC4 synthase using HPLC. Only LTA4 hydrolase enzymatic activity was found. This activity ranged from 101 to 667 when expressed as picomoles of LTB4 produced per milliliter BALF. Enzymatic activity in smokers vs nonsmokers was 484 +/- 120 vs 129 +/- 32 pmol LTB4/ml BALF (mean +/- SD, P < 0.0001). There were no leukotrienes found in BALF before assay. Immunoblot analysis revealed an immunoreactive band at a relative molecular mass of 69,000 D in all samples, consistent with LTA4 hydrolase, but no evidence of 5-lipoxygenase. BALF had greater LTA4 hydrolase activity per milligram of protein than neutrophil cytosol, epithelial cell cytosol, plasma, or serum. The synthesis of LTB4 was significantly increased when neutrophils were stimulated in BALF. These data indicate the selective presence of LTA4 hydrolase in BALF which is significantly increased in smokers. This enzyme in BALF may contribute to the inflammatory response in tobacco-related lung disease.     

Antimicrobial effects of lidocaine in bronchoalveolar lavage fluid

The antimicrobial activity of lidocaine in bronchoalveolar lavage fluid (BAL(f)) was investigated. Clinical respiratory isolates were added to BAL(f) suspensions containing lidocaine and to normal saline. The growth of two of four isolates of Streptococcus pneumoniae was significantly reduced in the presence of lidocaine-BAL(f) compared with controls in saline. Growth of Moraxella catarrhalis isolates was reduced in normal saline when compared with BAL(f) containing lidocaine. There was no effect upon the growth of Haemophilus influenzae, Pseudomonas aeruginosa and Candida albicans isolates. The recovery of isolates of S. pneumoniae may be reduced below the critical threshold of 10(5) cfu/mL during bronchoscopy when using lidocaine as a local anaesthetic.     

Inhibition of adenovirus-mediated gene transfer by bronchoalveolar lavage fluid.

Human and animal trials with recombinant adenovirus have been discouraging, since the level of recombinant gene expression was low. Nonspecific and specific immune response mediated by, for example, macrophages, T cells and immunoglobulins may prevent infection or cause death of infected cells. We analyzed the effect of bronchoalveolar lavage fluid (BAL) on the efficiency of adenoviral infection in vitro. A total of 26 BAL samples of randomly selected patients was examined. Adenovirus-mediated gene transfer was quantified using AdCMV. Null, a recombinant adenovirus, in a modified titer assay based on immunocytochemical detection of infected 293 cells. In addition, the concentration of anti-adenovirus-type 5 IgA, IgG and IgM antibodies in BAL was determined by ELISA. 53.8% of the BAL samples (14 out of 26) reduced adenoviral infectivity by at least 50% (factor of inhibition > or = 2). All BAL samples effecting, a reduction in adenoviral infectivity contained detectable amounts of anti-adenovirus-type 5-IgA antibodies. However, the correlation between the concentration of IgA antibody and the strength of inhibition was weak (r = 0.336). Even high levels of anti-adenovirus-type 5-IgM, IgG or IgA antibodies did not influence adenoviral infectivity consistently. This observation indicates that BAL contains (a) anti-adenovirus-type 5 antibodies which are not directed against adenoviral epitopes responsible for the viral adherence and uptake process; and/or (b) inhibitors of viral infectivity different from antibodies.     

Detection of tissue kallikrein in the bronchoalveolar lavage fluid of asthmatic subjects.

Kininogenase activity was detected by cleavage of radiolabeled substrate (125I-high molecular weight kininogen [HMWK]) in 22 of 24 bronchoalveolar lavage (BAL) fluid samples from 17 asthmatics who either responded to aerosolized allergen challenge or had symptoms of active asthma. In contrast, six of seven normal controls lacked enzymatic activity. Levels of free immunoreactive kinin found in BAL fluid correlated with the presence of kininogenase activity (P = 0.002). The cleavage pattern of 125I-HMWK by the BAL fluid kininogenase (a dominant 65,000-mol wt fragment), and synthetic inhibitor profile (phe-phe-arg-CH2Cl and phenylmethylsulfonyl fluoride) were compatible with a tissue kallikrein. Peak kininogenase activity eluted at an apparent molecular weight of 20,000-34,000 by HPLC gel filtration. Its antigenic identity was established by immunoblotting with anti-human urinary kallikrein antibody and its activity was inhibited by this antibody. Lysylbradykinin was generated during incubation of fractionated BAL fluid and purified HMWK, the characteristic cleavage product of the tissue kallikreins. We conclude that elevated amounts of tissue kallikrein and kinin are present in the bronchoalveolar spaces of asthmatic subjects. Kinin generation may contribute to the asthmatic response directly through edema formation and smooth muscle contraction and by augmenting release and/or production of preformed (histamine) and secondary mediators such as leukotrienes and platelet-activating factor.     

血清及支气管肺泡灌洗液半乳甘露聚糖检测对侵袭性肺曲霉感染的诊断价值

目的评价血清和支气管肺泡灌洗液(BALF)β半乳甘露聚糖(GM)检测对侵袭性肺曲霉感染的诊断价值。方法采集患者血清和肺泡灌洗液检测半乳甘露聚糖,计算不同阈值时的敏感度、特异度、阳性预测值和阴性预测值。结果共收集肺部感染86例,病例组20例,对照组66例。两组之间血和BALFGM差异均有统计学意义(P<0.01),病例组血和BALF之间差异有统计学意义(P<0.01);取0.75为诊断阈值,血清标本的敏感度、特异度,阳性预测值和阴性预测值分别为35.0%、95.5%、70.0%和82.9%;BALF为65.0%、90.9%、68.4%和89.6%。结论血清和BALFGM检测具有较高的特异度(80%～100%),BALF具有更高的敏感度和阴性预测值;对缺乏深部真菌感染诊断依据的肺部感染患者,血清及BALFGM明显增高可早期提示有发生侵袭性肺曲霉感染的可能。