【摘要】 目的 研究无肺部病变儿童经纤维支气管镜支气管肺泡灌洗液(BALF)细胞及肺表面活性物质成分。方法 应用细胞学、生化及免疫印迹法对20例无肺部病变的手术患儿的BALF进行细胞计数及肺表面活性物质成分分析。结果 BALF回收率为46.6％,其中细胞总数为156×10~3/mL,巨噬细胞占93.9％,淋巴细胞占4.5％。总磷脂(TPL)为46.6μg/mL,饱和卵磷脂(DSPC)为17.9μg/mL,总蛋白(TP)为72.2/μg/mL,DSPC/TPL为42.2％,DSPC/TP为0.28,肺表面活性物质蛋白A(SP-A)为1.91 μg/mL。细胞总数、TPL、TP、SP-A与年龄无显著相关。BAL对患儿心率、呼吸、经皮氧饱和度和血压无明显影响。结论 本研究的数值可以为判断肺泡水平生理学指标提供参考。更多还原

【Abstract】 Purpose To investigate cell type and surfactant components in bronchoalveolar lavage fluid (BALF) in anaesthetized children without pulmonary diseases. Methods The study group consisted of 20 children at median age of 3.7 yr (4 mo to 10.3 yr) undergoing surgery for nonpulmonary illness. A flexible bronchoscope ( working channel of 1. 2 mm and outer diameter of 2. 5 mm) was wedged into the middle lobe or one of its segments. BALF was obtained from repeated wash with 3×0.7 mL/kg body weight of normal saline warmed to body temperature. The first sample was discarded; and subsequent samples were pooled for analysis. The sediment after centrifugation was used for cytological analysis while the supernatant for mea-surement of total phospholipid (TPL), disaturated phosphatidylcholine (DSPC), total protein (TP) and surfactant protein A (SP-A). Results Median values for BALF recovery was 46. 6% and that for total cell counts (TCC) were 156 × 103/mL. The relative proportion of macrophages and lymphocytes was 93.9% and 4.5% , respectively. TPL was 46.6 μg/mL, DSPC 17. 9 μg/mL, TP 72.2 μg/mL, DSPC to TPL (DSPC/TPL) 42.2% , DSPC to TP ratio (DSPC/TP) 0.28 , and SP-A 1. 91 μg/mL. There was no significant correlation between TCC, TPL, TP, SP-A and age. Heart rate, respiration, oxygen saturation and blood pressure were not influenced. Conclusions The results of this study provided the basis for cy-tology and surfactant components of BALF in children, and may be referenced for understanding of physiolo-gy and pathophysiology of lung injury in children.更多还原