肺泡内吞噬脂肪的巨噬细胞对新生儿胃食管反流所致吸入综合征的诊断意义

目的　探讨肺泡内吞噬脂肪的巨噬细胞 (LLAM)在诊断新生儿胃食管反流 (GER)和肺部吸入综合征中的价值。方法　将 90例需机械通气的新生儿行食管 pH值 2 4h动态检测分析或钡剂食道造影 ,根据是否有GER将患儿分成两组 ,A组 :49例 ,有GER ;B组 :41例 ,无GER。将气管吸出物离心涂片用油红O染色检测LLAM。结果　A组共有 42例LLAM阳性 ,阳性率为 85 7% ;B组仅有 7例LLAM阳性 ,阳性率为 17 1% ,两组间差别有显著意义 (P <0 0 1)。LLAM对GER的诊断敏感性为 85 7% ,特异性为 82 9% ,假阳性率为 17 1%。结论　气管吸出物检测LLAM对新生儿GER和肺部吸入综合征的诊断具有重要意义 ,该方法敏感性和特异性较高 ,且简便、快捷、经济 ,值得推广应用

Diagnostic significance of lipid-laden alveolar macrophages in neonatal gastroesophageal reflux

Objective To Study Lipid-laden alveolar macrophages (LLAM) in the diagnosis of neonatal gastroesophageal reflux (GER) and aspiration syndrome.Methods Ninety neonates who required mechanical ventilation underwent 24 hour intra-esophageal pH monitoring and barium esophagram and were divided into two groups: 49 cases with GER in Group A and 41 cases without GER in Group B. Results 42 patients in Group A were LLAM-positive with a positive rate of 85.7%;7 patients in Group B were LLAM-positive with a positive rate of 17.1%. There was significant difference between the two groups(P<0.01). LLAM had a diagnostic sensitivity of 85.7%, a specificity of 82.9% and a false positive rate of 17.1%.Conclusion LLAM in tracheal aspirate is useful for the diagnosis of neonatal GER and aspiration syndrome. It is a sensitive, specific, simple, rapid and economic method recommended for widely usage.