碱性成纤维细胞生长因子在治疗吸入性损伤中的疗效观察

目的：观察碱性成纤维细胞生长因子（BFGF）对吸入性损伤后气道粘膜及肺泡上皮的修复作用。方法：依据纤支镜结果将中、重度吸入性损伤分别随机分为BFGF治疗组与对照组。在相应时段进行纤支镜支气管肺泡灌洗术,摄像记录纤支镜所见及检测支气管肺泡灌洗液（BALF）中蛋白质含量、胶体渗透压（COP）与细胞分类计数。结果：在中、重度吸入性损伤中,其气道修复时间BFGF治疗组比对照组平均提前4．5天与3．3天;发生出血、气管支气管狭窄等并发症的机率平均降低64．65及31．9％。BFGF治疗组的BALF中总蛋白（TP）、白蛋白（ALb）、COP以及细胞总数、中性粒细胞、淋巴细胞数量均比对照组明显降低（P＜0．05）。结论：BFGF治疗中、重度吸入性损伤,能促进气道粘膜及肺泡上皮的修复。     

慢性阻塞性肺病大鼠模型的建立及药物干预的影响

目的：寻求建立慢性阻塞性肺病（COPD）大鼠模型的新方法,探讨吸入皮质激素布地奈德及抗胆碱能受体支气管扩张剂溴化异丙托品（异丙托品）对大鼠COPD模型干预的影响。方法：用两次气管内注入脂多糖（LPS200μg/次）及熏香烟4周的复合刺激法建立大鼠COPD模型（模型组）,药物干预组于制作模型后第8天起分别吸入布地奈德及异丙托品溶液。观察支气管病理学改变及支气管肺泡灌洗液（BALF）细胞计数与分类,检测有关呼吸功能指标。结果：模型组气管、支气管及肺组织有慢性支气管炎、阻塞性肺气肿的特征性病理改变;气管壁厚度及腺体厚度／气管壁厚度的比值显著高于对照组（P＜0．01－0．001）;BALF中白细胞总数及中性粒细胞数较对照组显著增高（P＜0．01）,静息分钟通气量（VE）、呼气峰流速（PEF）和“0．3s用力呼气容积”（“FEV0．3”）则显著降低（P＜0．05）。与模型组相比,布地奈德组白细胞总数及中性粒细胞数显著降低,单核－巨噬细胞所占构成比显著升高（P＜0．05）,异丙托品组则无显著差异（P＞0．05）。结论：采用两次气管内注入适量LPS和反复熏香烟的方法,可成功制备大鼠COPD模型,其病理及病生理改变与人类COPD类似,为人类COPD研究提供了一个新工具。皮质激素对大鼠COPD模型有一定保护作用。     

实验性肺纤维化肺灌洗液磷脂组分分析

对博莱霉素肺纤维化大鼠模型不同时期作支气管肺泡灌洗液(BALF)细胞计数与分类、蛋白含量测定和磷脂及其组分测定,并与肺病理变化作对照分析。结果发现BALF细胞计数和分类与肺组织细胞浸润基本一致,BALF蛋白含量增加,磷脂酰甘油(PG)随病变进展而下降,磷脂酰肌醇(PI)和磷脂酰乙醇胺(PE)升高。PG／PI比值下降,PG／PI比值可作为肺纤维化的一种标志。     

Expression of activation markers on alveolar macrophages in allergic asthmatics after endobronchial or whole-lung allergen challenge

We examined the effect of endobronchial (EB) or whole-lung (WL) challenge with ragweed or Timothy grass extract on alveolar macrophage (AM) activation. Expression of 17 constitutive activation markers on AM was examined by flow cytometry. Late-phase bronchial obstruction was greater after WL challenge, while changes in bronchoalveolar lavage cytology (eosinophil accumulation) were greater after EB challenge. After EB challenge, levels of 10 of 17 markers (CD11a, CD11b, CD14, CD18, CD23, CD32, CD63, CD64, HLA-class I, and HLA-DR) were significantly increased (by 33-234%, P < 0.05). Six markers (CD16, CD29, CD33, CD35, CD44, CD71, and HLA-DQ) remained unchanged. Levels of seven markers following EB challenge (CD14, CD16, CD18, CD29, CD32, HLA-class I, and HLA DQ) correlated with airway sensitivity to methacholine. WL challenge only increased expression of HLA-class I. The different results obtained with the two challenge methods probably depend on higher local concentrations of allergen in the EB challenge. We suggest that activation of AM occurs following EB challenge with antigen in asthmatics.     

Interleukin-6 in bronchoalveolar lavage fluid from patients with COPD

目的　本研究通过检测支气管肺灌洗液 (BALF)中及肺泡巨噬细胞 (AM)产生的IL 6 ,揭示IL 6与慢性支气管炎(COPD)肺气肿发生的关系 ,为IL 6提供新的研究领域。方法　检测 6名正常无吸烟人及 2 1名COPD患者BALF中及AM释放的IL 6 ,根据正常人组BALF中IL 6的 95 %正常值可信区限 ,将COPD患者分为二组 ,在正常值可信区限内为第一组 ,在正常值可信区限外为第二组。结果　表明 2组中AM产生的IL 6第二组明显高于第一组 ,且 2组患者肺功能 (Dlco ,FEV1,FEV1/FVC和RV/TLC)有明显差异结论　AM产生的IL 6可能与COPD患者肺功能变化有关 ,在COPD患者肺气肿发生发展过程中发挥重要作用     

Inflammation markers in nasal lavage, and nasal symptoms in relation to relocation to a newly painted building: a longitudinal study

Introduction: There is a need to evaluate possible health effects of ventilation improvements and emissions from new buildings, in longitudinal studies. New methods to study biological effects on the eyes and upper airways are now available. Material and methods: A longitudinal study was performed on 83 trained social workers in two offices in Uppsala, Sweden. The exposed group (n= 57) moved to a newly redecorated building nearby. Low emitting building material had been used, including a new type of solvent-free water-based paint. The control group (n= 26) worked in the same office during the study period (November 1995 to February 1996). Hygiene management was carried out in both offices, at the beginning and the end of the investigation. Tear film stability (BUT) was measured. Nasal patency was measured by acoustic rhinometry, and eosinophilic cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin were analyzed in nasal lavage fluid (NAL). Results: The relocation resulted in an increase in the personal outdoor airflow rate from 11 to 22 l/s. Indoor concentrations of terpenes were higher in the new building, and powdering of the new linoleum floor was observed. Measurements showed low levels of volatile organic compounds (VOC), formaldehyde, carbon dioxide (CO₂), nitrogen dioxide, respirable dust, and microorganisms in the air of all buildings. The move resulted in an increased nasal patency and an increase of ECP and lysozyme in NAL, after adjusting for changes in the control group. No changes were observed for nasal or ocular symptoms. A seasonal effect, with a decrease of ECP, was observed in the control group. Conclusion: A well-ventilated office building can be redecorated without any major ocular or nasal effects, or measurable increase of indoor air pollution if low-emitting building materials are selected. In agreement with previous evidence, the improved ventilation flow may explain the increase of nasal patency. The increase of ECP and lysozyme in NAL suggested an inflammatory effect in the new building. Since this building had increased ventilation flow, increased concentrations of terpenes, and powdering from the polish on the new linoleum floor, identification of causative agents was difficult. The hygiene measures did not give any evidence that emissions from the new type of solvent-free water-based paints or building dampness were responsible for the observed nasal effects. Considering the higher emissions of VOC reported from older types of water-based latex paints and solvent-based wall paints, the new type of solvent-free water-based paint seems to be a good choice from the hygiene point of view. Received: 21 December 1998 / Accepted: 20 June 1999     

Acceptance and effects of nasal lavage in volunteer woodworkers

Wood dust is an irritant and is carcinogenic to the nasal mucosa. It inhibits its own clearance from the nose. It therefore makes sense to lavage retained wood dust from the nose following exposure. To our knowledge this is the second study conducted to determine whether the procedure of nasal lavage reduces nasal symptoms in woodworkers. Forty-six woodworkers from 150 approached volunteered to trial nasal lavage using gravity fed, home-made unbuffered isotonic saline for 2 months in a crossover trial and then be followed-up a year later. The group reported significantly decreased nasal symptoms and over half continued to use nasal lavage voluntarily after 1 year. Results support the findings of the previous study that nasal lavage improves nasal symptoms and supplements those findings with data indicating patterns of voluntary usage following the study's conclusion. It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.     

间质性肺疾病支气管肺泡灌洗液中内皮素的检测及其意义

目的　探讨内皮素 ( ET)在间质性肺疾病 ( ILD)发生发展中的作用及其诊断价值。方法　利用放射免疫直接测定法 ,检测 1 0例肺结节病和 8例特发性肺纤维化 ( IPF)患者外周血和支气管肺泡灌洗液 ( BALF)中内皮素的含量 ,并与 8例健康非吸烟者对照。结果　肺结节病和 IPF患者血浆和 BAL F中 ET的含量分别为 62 .1 4± 2 9.2 2 ng/L ,1 7.4 0± 2 .4 1 ng/L和 76.92± 71 .90 ng/L,1 0 .4 0± 3.1 3ng/L,均明显高于正常对照组 ( 2 0 .0 8± 8.37ng/L 和 4 .0 4± 0 .5 5 ng/L) ,P <0 .0 1 ;研究组 BALF中 ET与 Pa O2 呈负相关 ( r=- 0 .5 38,P<0 .0 1 ) ,与细胞总数呈正相关 ( r =0 .64 9,P <0 .0 1 )。其中结节病和 IPF的 BAL F中 ET水平分别与淋巴细胞和中性粒细胞呈明显正相关 ( r =0 .71 2 ,P <0 .0 1 ;r =0 .81 3,P <0 .0 1 )。结论　 ET在肺结节病和 IPF发生发展中起重要作用 ,并可做为判断疾病活动性的一项参考指标。     

常见大气细菌对动物肺损伤的实验研究

为研究大气微生物对人体健康的影响,于１９９７年对上海市大气细菌污染进行了调查。在此基础上,采用大鼠经气管灌注细菌悬液２４小时后,分析肺灌洗液组成的方法,就大气细菌对动物呼吸系统损伤方面进行了研究。同时比较了不同地区大气细菌对大鼠肺细胞的损伤效应。结果发现大气细菌污染严重地区的细菌染毒组ＡＬＢ、ＬＤＨ、ＡＣＰ、ＡＫＰ、中性粒细胞等指标比清洁区升高更为显著,提示大气中常见细菌可对肺组织造成损伤。     

肺癌患者血清与支气管肺泡灌洗液四项放免肿瘤指标同步检测的结果分析

对３８例肺癌患者的血清和支气管肺泡灌洗液（ＢＡＬＦ）同步进行ＣＥＡ、ＣＡ－５０、ＡＦＰ、ＳＦ的检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ浓度测值７３％明显高于血清中ＣＥＡ浓度;ＣＡ－５０浓度测值６８％高于血清;ＳＦ９２％明显低于血清中测值;而ＡＦＰ在肺癌患者无论血清及灌洗液中,阳性率均低于７％,但仍是ＢＡＬＦ的浓度测值敏感于血清。提示支气管肺泡灌洗液的ＣＥＡ、ＣＡ－５０与血清的同步检测是目前肺癌早期诊断的主要优选方法之一。