间质性肺疾病支气管肺泡灌洗液的酶活性研究

目的探讨支气管肺泡灌洗液（ＢＡＬＦ）多项酶活性与间质性肺疾病（ＩＬＤ）的关系。方法检测３０例ＩＬＤｓ：包括特发性肺纤维化（ＩＰＦ）１８例和结节病（Ｓａｒｃ）１２例与９例正常对照者的ＢＡＬＦ中超氧化歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－ＰＸ）、血管紧张素转换酶（ＡＣＥ）和乳酸脱氢酶（ＬＤＨ）活性，并分类计数ＢＡＬＦ细胞成份。结果（１）ＩＰＦ组ＢＡＬＦ中各项酶活性均与对照组间差异有显著性（ＳＯＤ和ＧＳＨ－ＰＸ降低，ＡＣＥ和ＬＤＨ升高）（Ｐ＜０．０５）；而Ｓａｒｃ组仅见ＡＣＥ明显增高（Ｐ＜０．０５）。（２）ＢＡＬＦ－ＡＣＥ与Ｓａｒｃ组淋巴细胞百分比及ＣＤ＋４／ＣＤ＋８比值均有显著线性相关（Ｐ＜０．０５）。结论ＢＡＬＦ中ＳＯＤ、ＧＳＨ－ＰＸ、ＡＣＥ和ＬＤＨ活性测定，有助于进一步探讨ＩＬＤ发病机理和提供辅助诊断依据，ＢＡＬＦ－ＡＣＥ对判断Ｓａｒｃ活动性有重要临床意义。

A study on enzymatic activities of bronchoalveolar lavage fluid in patients with interstitial lung diseases

Objective To evaluate the relationship between enzymatic activities in bronchoalveolar lavage fluid(BALF) and interstitial lung diseases(ILDs). Method Cellular components and levels of superoxide dismutase (SOD), glutathione peroxidase(GSH PX) , angiotensin converting enzyme(ACE) and lactate dehydrogenase(LDH) in BALF in 30 cases of ILDs: including 18 patients with idiopathic pulmonary fibrosis (IPF) and 12 patients with sarcoidosis (Sarc) and 9 healthy controls were determined. Result (1)The levels of BALF SOD, GSH PX were significantly decreased( P <0.01), and BALF ACE, LDH were markedly increased ( P <0.05) in patients with IPF, and BALF ACE were also increased in patients with Sarc( P < 0.05 ); (2) There were good correlation between ACE and percentage of lymphocyte ( r 1=0.6574, P <0.05 ), and ratio of CD 4/CD 8( r 2=0.9544, P <0.001)in BALF of Sarc group. Conclusion Determing enzymatic activities could be helpful to study pathogenesis and diagnosis of ILDs, BALF ACE may be as a good marker of disease activity of Sarcoidosis.